Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › SAN ANTONIO › PEDIATRIC PRIVATE DUTY NURSING, INC

PEDIATRIC PRIVATE DUTY NURSING, INC

NPI: 1821413287 · SAN ANTONIO, TX 78255 · Nursing Care Agency · NPI assigned 02/21/2014

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

97% of spending on code T1000 with only 2 total codes billed. Highly concentrated billing profile.

$50.08M
Total Medicaid Paid
104,194
Total Claims
3,524
Beneficiaries
2
Codes Billed
2019-07
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPENA, EDWARD (CEO)
NPI Enumeration Date02/21/2014

Related Entities

Other providers sharing the same authorized official: PENA, EDWARD

ProviderCityStateTotal Paid
PEDIATRIC HEALTH THERAPY, INC SAN ANTONIO TX $474K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 173 $88K
2020 5,560 $2.75M
2021 26,465 $12.98M
2022 23,081 $11.47M
2023 25,896 $11.89M
2024 23,019 $10.91M

Billing Codes

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