PRIME ONE CARE LLC
NPI: 1942887179
· POMONA, CA 91767
· Adult Day Care Clinic/Center
· NPI assigned 03/25/2021
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
99% of spending on code S5102 with only 2 total codes billed. Highly concentrated billing profile.
$2.61M
Total Medicaid Paid
Provider Details
| Authorized Official | HAN, DONALD (PRESIDENT) |
| NPI Enumeration Date | 03/25/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
342 |
$21K |
| 2023 |
17,499 |
$1.21M |
| 2024 |
20,259 |
$1.38M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5102 |
Day care services, adult; per diem |
37,721 |
3,246 |
$2.58M |
| H2000 |
Comprehensive multidisciplinary evaluation |
379 |
142 |
$28K |