ADVANCED CARE PEDIATRICS OF FLORIDA, LLC
NPI: 1861976615
· PORT ST LUCIE, FL 34953
· Medically Fragile Infants and Children Day Care
· NPI assigned 09/18/2018
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
98% of spending on code T1025 with only 2 total codes billed. Highly concentrated billing profile.
$6.79M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
4,165 |
$538K |
| 2020 |
4,484 |
$687K |
| 2021 |
6,533 |
$971K |
| 2022 |
5,594 |
$1.06M |
| 2023 |
9,883 |
$2.06M |
| 2024 |
6,366 |
$1.47M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1025 |
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem |
35,756 |
2,375 |
$6.64M |
| T1026 |
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour |
1,269 |
213 |
$152K |