Is E & R HEALTH CARE INC flagged for Medicaid fraud?

E & R HEALTH CARE INC (NPI: 1235401357) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does E & R HEALTH CARE INC bill Medicaid?

E & R HEALTH CARE INC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Home Health provider. Located in SWEETWATER, FL.

What is NPI 1235401357?

NPI 1235401357 is the National Provider Identifier for E & R HEALTH CARE INC. They are a Home Health provider based in SWEETWATER, FL. This NPI is registered with the CMS NPI Registry.

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E & R HEALTH CARE INC

Home Health·SWEETWATER, FL·NPI: 1235401357Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $46.7M is at the below 25th percentile among 322 Home Health providers.

Active Billing Period:2019-01→2024-12(72 months)

Total Paid

$46.7M

$46,748,437

Total Claims

1.6M

Beneficiaries

71K

22.5 claims/patient

Avg Cost/Claim

$29

Monthly Spending Trend

Yearly Spending

2019

$842K

+48%

2020

$1.2M

+332%

2021

$5.4M

+65%

2022

$8.9M

+63%

2023

$14.5M

+10%

2024

$15.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 50% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1019Personal care services, per 15 minSee all providers →

$23.3M

672K claims

$34.61

$82.47

0.4×

Normal range

T1019Normal range

Personal care services, per 15 min

$23.3M

672K claims · 49.7%

Your Cost: $34.61/claim|Median: $82.47

0.4× median

S5130Homemaker service, NOS; per 15 minSee all providers →

$12.3M

560K claims

$22.00

$48.76

0.5×

Normal range

S5130Normal range

Homemaker service, NOS; per 15 min

$12.3M

560K claims · 26.4%

Your Cost: $22.00/claim|Median: $48.76

0.5× median

S5135Companion care, adult, per diemSee all providers →

$3.9M

175K claims

$22.23

$52.25

0.4×

Normal range

S5135Normal range

Companion care, adult, per diem

$3.9M

175K claims · 8.3%

Your Cost: $22.23/claim|Median: $52.25

0.4× median

S9122Home health aide or certified nurse, per hourSee all providers →

$3.1M

47K claims

$66.79

$116.67

0.6×

Normal range

S9122Normal range

Home health aide or certified nurse, per hour

$3.1M

47K claims · 6.7%

Your Cost: $66.79/claim|Median: $116.67

0.6× median

T1004Services of a qualified nursing aide, per 15 minutesSee all providers →

$2.1M

42K claims

$50.16

$50.30

1.0×

Normal range

T1004Normal range

Services of a qualified nursing aide, per 15 minutes

$2.1M

42K claims · 4.5%

Your Cost: $50.16/claim|Median: $50.30

1.0× median

S5150Unskilled respite care, per 15 minSee all providers →

$1.4M

99K claims

$14.39

$84.46

0.2×

Normal range

S5150Normal range

Unskilled respite care, per 15 min

$1.4M

99K claims · 3.0%

Your Cost: $14.39/claim|Median: $84.46

0.2× median

97110Therapeutic exercises, each 15 minSee all providers →

$417K

4,857 claims

$85.95

$24.49

3.5×

Top 5%

97110Top 5%

Therapeutic exercises, each 15 min

$417K

4,857 claims · 0.9%

Your Cost: $85.95/claim|Median: $24.49

3.5× median

T1002RN services, per 15 minutesSee all providers →

$209K

1,826 claims

$114.26

$37.42

3.1×

Top 25%

T1002Top 25%

RN services, per 15 minutes

$209K

1,826 claims · 0.4%

Your Cost: $114.26/claim|Median: $37.42

3.1× median

Q5001Injection, filgrastim-sndz, biosimilar, 1 mcgSee all providers →

371 claims

$0.00

$23.43

—

Normal range

Q5001Normal range

Injection, filgrastim-sndz, biosimilar, 1 mcg

371 claims · 0.0%

Your Cost: $0.00/claim|Median: $23.43

G0151Physical therapy services, home health, per visitSee all providers →

388 claims

$0.00

$67.94

—

Normal range

G0151Normal range

Physical therapy services, home health, per visit

388 claims · 0.0%

Your Cost: $0.00/claim|Median: $67.94

G0299Skilled nursing services, home health, per visit, RNSee all providers →

4,065 claims

$0.00

$51.67

—

Normal range

G0299Normal range

Skilled nursing services, home health, per visit, RN

4,065 claims · 0.0%

Your Cost: $0.00/claim|Median: $51.67

G0157Services of PT assistant in home health, per 15 minSee all providers →

1,212 claims

$0.00

$43.94

—

Normal range

G0157Normal range

Services of PT assistant in home health, per 15 min

1,212 claims · 0.0%

Your Cost: $0.00/claim|Median: $43.94

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