Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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CHILDREN'S SERVICE CENTER OF WYOMING VALLEY

NPI: 1609090893 · WILKES BARRE, PA 18702 · Community/Behavioral Health Agency · NPI assigned 04/12/2007

Billing Flags · Automated signals — not evidence of fraud
Single-Code Concentration

93% of spending on code H0004 with only 2 total codes billed. Highly concentrated billing profile.

$4.68M
Total Medicaid Paid
20,326
Total Claims
4,233
Beneficiaries
2
Codes Billed
2020-09
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSIMMONS, BARRY (VP FINANCE)
NPI Enumeration Date04/12/2007

Related Entities

Other providers sharing the same authorized official: SIMMONS, BARRY

ProviderCityStateTotal Paid
CHILDREN'S SERVICE CENTER WILKES BARRE PA $26.00M
CHILDREN'S SERVICE CENTER OF WYOMING VALLEY WILKES BARRE PA $18.65M
CHILDREN'S SERVICE CENTER OF WYOMING VALLEY WILKES BARRE PA $1.48M
CHILDREN'S SERVICE CENTER OF WYOMING VALLEY WILKES BARRE PA $1.03M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 1,830 $308K
2021 6,752 $1.25M
2022 5,026 $1.12M
2023 3,748 $1.07M
2024 2,970 $930K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0004 Behavioral health counseling and therapy, per 15 minutes 17,009 2,853 $4.34M
T1016 Case management, each 15 minutes 3,317 1,380 $338K