Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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RISE PLLC

NPI: 1780929752 · WILBURTON, OK 74578 · Case Management Agency · NPI assigned 12/03/2012

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

90% of spending on code H0004 with only 2 total codes billed. Highly concentrated billing profile.

$1.33M
Total Medicaid Paid
20,487
Total Claims
3,954
Beneficiaries
2
Codes Billed
2018-01
First Month
2020-09
Last Month

Provider Details

Authorized OfficialNELSON, GARY (CEO/OWNER)
NPI Enumeration Date12/03/2012

Related Entities

Other providers sharing the same authorized official: NELSON, GARY

ProviderCityStateTotal Paid
NELSON COUNSELING L.L.C DELRAN NJ $44K

Monthly Spending Trend

Yearly Breakdown

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

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0004 Behavioral health counseling and therapy, per 15 minutes 18,143 3,526 $1.20M
H2017 Psychosocial rehabilitation services, per 15 minutes 2,344 428 $128K