Rise PLLC

Rise PLLC was paid $1.33M by Medicaid between Jan 2018 and Sep 2020, across 2 billing codes. Its largest line is H0004, Behavioral health counseling and therapy, per 15 minutes — 90% of everything it billed.

33Billing provider infoRISE PLLC
WILBURTON, OK 74578

33aNPI1780929752assigned 12/03/2012

33bProvider typeCase Management Agency

28Total paid$1.33M

24GClaims20,487

24DCodes billed2

24AFirst – last monthJan 2018 – Sep 2020

Compared with peers

Next to other Case Management Agency providers in Oklahoma

Rank by total paid#38 of 62

Median peer was paid$1.88M

This provider vs. median0.7×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration90% of spending on code H0004 with only 2 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	9,947	$624K
2019	7,261	$487K
2020	3,279	$220K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0004	Behavioral health counseling and therapy, per 15 minutes	90%	18,143	3,526	$1.20M
H2017	Psychosocial rehabilitation, billed per 15 minutesPsychosocial rehabilitation services, per 15 minutes	9.6%	2,344	428	$128K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialNELSON, GARY (CEO/OWNER)

Same official

Other billing entities under NELSON, GARY

Full network →

Provider	Location	Paid
Nelson Counseling L.L.C	Delran, NJ	$44K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.