Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Agency

Pediatric Private Duty Nursing, INC

Pediatric Private Duty Nursing, INC was paid $50.08M by Medicaid between Jul 2019 and Dec 2024, across 2 billing codes. Its largest line is T1000, Private duty / independent nursing service(s) - licensed, up to 15 minutes — 97% of everything it billed.

33Billing provider infoPEDIATRIC PRIVATE DUTY NURSING, INC
SAN ANTONIO, TX 78255
33aNPI1821413287assigned 02/21/2014
33bProvider typeNursing Care Agency
28Total paid$50.08M
24GClaims104,194
24DCodes billed2
24AFirst – last monthJul 2019 – Dec 2024
Compared with peers

Next to other Nursing Care Agency providers in Texas

Rank by total paid#9 of 162
Median peer was paid$5.72M
This provider vs. median8.8×

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 Concentration97% of spending on code T1000 with only 2 total codes billed. Highly concentrated billing profile.
Box 24A · Dates of service

Paid by month

$0$500K$1.0M$1.5M2018201920202021202220232024
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
YearClaimsPaid
2019173$88K
20205,560$2.75M
202126,465$12.98M
202223,081$11.47M
202325,896$11.89M
2024incomplete23,019$10.91M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
T1000 Private duty / independent nursing service(s) - licensed, up to 15 minutes 97% 99,774 3,377 $48.81M
S9124 Nursing care, in the home; by licensed practical nurse, per hour 2.5% 4,420 147 $1.27M

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 officialPENA, EDWARD (CEO)
Same official

Other billing entities under PENA, EDWARD

Full network →
ProviderLocationPaid
Pediatric Health Therapy, INCSan Antonio, TX$474K

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