Is AGUA CRISTALINA HOME CARE, LLC flagged for Medicaid fraud?

AGUA CRISTALINA HOME CARE, LLC (NPI: 1346579265) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does AGUA CRISTALINA HOME CARE, LLC bill Medicaid?

AGUA CRISTALINA HOME CARE, LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Home Health provider. Located in HARLINGEN, TX.

What is NPI 1346579265?

NPI 1346579265 is the National Provider Identifier for AGUA CRISTALINA HOME CARE, LLC. They are a Home Health provider based in HARLINGEN, TX. This NPI is registered with the CMS NPI Registry.

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AGUA CRISTALINA HOME CARE, LLC

Home Health·HARLINGEN, TX·NPI: 1346579265Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $107.9M is at the 25th percentile among 322 Home Health providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$107.9M

$107,914,410

Total Claims

1.6M

Beneficiaries

78K

20.6 claims/patient

Avg Cost/Claim

$67

Monthly Spending Trend

Yearly Spending

2018

$5.0M

+32%

2019

$6.6M

+50%

2020

$9.8M

+58%

2021

$15.6M

+34%

2022

$20.8M

+2%

2023

$21.3M

+35%

2024

$28.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 48% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

S5125Attendant care services, per 15 minSee all providers →

$51.7M

944K claims

$54.80

$82.34

0.7×

Normal range

S5125Normal range

Attendant care services, per 15 min

$51.7M

944K claims · 47.9%

Your Cost: $54.80/claim|Median: $82.34

0.7× median

T2026Specialized transportation, waiver, per tripSee all providers →

$38.6M

256K claims

$150.74

$170.05

0.9×

Normal range

T2026Normal range

Specialized transportation, waiver, per trip

$38.6M

256K claims · 35.8%

Your Cost: $150.74/claim|Median: $170.05

0.9× median

G0100 See all providers →

$4.0M

63K claims

$64.20

$82.82

0.8×

Normal range

G0100Normal range

$4.0M

63K claims · 3.7%

Your Cost: $64.20/claim|Median: $82.82

0.8× median

T1005Respite care services, per 15 minutesSee all providers →

$3.8M

113K claims

$33.26

$71.40

0.5×

Normal range

T1005Normal range

Respite care services, per 15 minutes

$3.8M

113K claims · 3.5%

Your Cost: $33.26/claim|Median: $71.40

0.5× median

T1019Personal care services, per 15 minSee all providers →

$3.5M

112K claims

$31.43

$82.47

0.4×

Normal range

T1019Normal range

Personal care services, per 15 min

$3.5M

112K claims · 3.3%

Your Cost: $31.43/claim|Median: $82.47

0.4× median

97124 See all providers →

$2.5M

28K claims

$88.58

$17.78

5.0×

Top 10%

97124Top 10%

$2.5M

28K claims · 2.3%

Your Cost: $88.58/claim|Median: $17.78

5.0× median

G0176Activity therapy (group), per sessionSee all providers →

$1.3M

15K claims

$85.96

$85.09

1.0×

Normal range

G0176Normal range

Activity therapy (group), per session

$1.3M

15K claims · 1.2%

Your Cost: $85.96/claim|Median: $85.09

1.0× median

H2032Activity therapy, per 15 minutesSee all providers →

$1.1M

8,380 claims

$136.43

$108.23

1.3×

Normal range

H2032Normal range

Activity therapy, per 15 minutes

$1.1M

8,380 claims · 1.1%

Your Cost: $136.43/claim|Median: $108.23

1.3× median

T2017Habilitation, residential, waiver; 15 minSee all providers →

$806K

13K claims

$64.23

$137.32

0.5×

Normal range

T2017Normal range

Habilitation, residential, waiver; 15 min

$806K

13K claims · 0.7%

Your Cost: $64.23/claim|Median: $137.32

0.5× median

G0648 See all providers →

$488K

52K claims

$9.45

$13.92

0.7×

Normal range

G0648Normal range

$488K

52K claims · 0.5%

Your Cost: $9.45/claim|Median: $13.92

0.7× median

T1002RN services, per 15 minutesSee all providers →

$47K

785 claims

$60.26

$37.42

1.6×

Normal range

T1002Normal range

RN services, per 15 minutes

$47K

785 claims · 0.0%

Your Cost: $60.26/claim|Median: $37.42

1.6× median

S5199Personal care item, NOS, eachSee all providers →

$8K

40 claims

$188.83

$10.82

17.5×

Top 5%

S5199Top 5%

Personal care item, NOS, each

$8K

40 claims · 0.0%

Your Cost: $188.83/claim|Median: $10.82

17.5× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$6K

58 claims

$110.04

$84.12

1.3×

Normal range

H2019Normal range

Therapeutic behavioral services, per 15 min

$6K

58 claims · 0.0%

Your Cost: $110.04/claim|Median: $84.12

1.3× median

G0152Occupational therapy services, home health, per visitSee all providers →

$6K

80 claims

$72.65

$68.93

1.1×

Normal range

G0152Normal range

Occupational therapy services, home health, per visit

$6K

80 claims · 0.0%

Your Cost: $72.65/claim|Median: $68.93

1.1× median

T2024Supported employment, waiver, per diemSee all providers →

$4K

277 claims

$15.98

$259.38

0.1×

Normal range

T2024Normal range

Supported employment, waiver, per diem

$4K

277 claims · 0.0%

Your Cost: $15.98/claim|Median: $259.38

0.1× median

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