Is NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC flagged for Medicaid fraud?

NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC (NPI: 1811207848) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC bill Medicaid?

NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC 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 SAN ANTONIO, TX.

What is NPI 1811207848?

NPI 1811207848 is the National Provider Identifier for NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC. They are a Home Health provider based in SAN ANTONIO, TX. This NPI is registered with the CMS NPI Registry.

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NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC

Home Health·SAN ANTONIO, TX·NPI: 1811207848Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $46.3M is at the below 25th percentile among 322 Home Health providers.

Active Billing Period:2019-07→2024-12(56 months)

Total Paid

$46.3M

$46,253,170

Total Claims

298K

Beneficiaries

51K

5.9 claims/patient

Avg Cost/Claim

$155

Monthly Spending Trend

Yearly Spending

2019

$6K

+19794%

2020

$1.1M

+562%

2021

$7.2M

+16%

2022

$8.4M

+56%

2023

$13.1M

+24%

2024

$16.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T1000 (Private duty/independent nursing service(s))) accounts for 49% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1000Private duty/independent nursing service(s)See all providers →

$22.7M

58K claims

$394.29

$402.76

1.0×

Normal range

T1000Normal range

Private duty/independent nursing service(s)

$22.7M

58K claims · 49.1%

Your Cost: $394.29/claim|Median: $402.76

1.0× median

92507Speech/hearing/language treatmentSee all providers →

$15.6M

165K claims

$94.80

$49.45

1.9×

Top 10%

92507Top 10%

Speech/hearing/language treatment

$15.6M

165K claims · 33.8%

Your Cost: $94.80/claim|Median: $49.45

1.9× median

97530Therapeutic activities, each 15 minSee all providers →

$4.6M

44K claims

$104.39

$33.11

3.2×

Top 5%

97530Top 5%

Therapeutic activities, each 15 min

$4.6M

44K claims · 10.0%

Your Cost: $104.39/claim|Median: $33.11

3.2× median

97110Therapeutic exercises, each 15 minSee all providers →

$1.9M

20K claims

$91.66

$24.49

3.7×

Top 5%

97110Top 5%

Therapeutic exercises, each 15 min

$1.9M

20K claims · 4.0%

Your Cost: $91.66/claim|Median: $24.49

3.7× median

92526Treatment of swallowing dysfunction and/or oral functionSee all providers →

$636K

5,109 claims

$124.42

$49.74

2.5×

Top 5%

92526Top 5%

Treatment of swallowing dysfunction and/or oral function

$636K

5,109 claims · 1.4%

Your Cost: $124.42/claim|Median: $49.74

2.5× median

92523Evaluation of speech sound production with language comprehensionSee all providers →

$295K

1,741 claims

$169.42

$110.87

1.5×

Top 25%

92523Top 25%

Evaluation of speech sound production with language comprehension

$295K

1,741 claims · 0.6%

Your Cost: $169.42/claim|Median: $110.87

1.5× median

S9152Speech therapy, re-evaluationSee all providers →

$274K

1,990 claims

$137.88

$92.99

1.5×

Top 10%

S9152Top 10%

Speech therapy, re-evaluation

$274K

1,990 claims · 0.6%

Your Cost: $137.88/claim|Median: $92.99

1.5× median

T1005Respite care services, per 15 minutesSee all providers →

$98K

764 claims

$128.90

$71.40

1.8×

Top 25%

T1005Top 25%

Respite care services, per 15 minutes

$98K

764 claims · 0.2%

Your Cost: $128.90/claim|Median: $71.40

1.8× median

97168OT re-evaluationSee all providers →

$62K

592 claims

$103.95

$50.43

2.1×

Top 25%

97168Top 25%

OT re-evaluation

$62K

592 claims · 0.1%

Your Cost: $103.95/claim|Median: $50.43

2.1× median

97166OT evaluation, moderate complexitySee all providers →

$34K

279 claims

$120.26

$48.74

2.5×

Top 10%

97166Top 10%

OT evaluation, moderate complexity

$34K

279 claims · 0.1%

Your Cost: $120.26/claim|Median: $48.74

2.5× median

97162PT evaluation, moderate complexitySee all providers →

$21K

173 claims

$120.94

$46.10

2.6×

Top 10%

97162Top 10%

PT evaluation, moderate complexity

$21K

173 claims · 0.0%

Your Cost: $120.94/claim|Median: $46.10

2.6× median

97164PT re-evaluationSee all providers →

$13K

129 claims

$100.33

$32.66

3.1×

Top 5%

97164Top 5%

PT re-evaluation

$13K

129 claims · 0.0%

Your Cost: $100.33/claim|Median: $32.66

3.1× median

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