MERIDA AMARILIS VALERA, LPCA
NPI 1285132514, individual, Winston Salem, NC, Counselor, Mental Health
- Billed more hands-on hours than a day holds in 9 months, peaking at 28.4 hours per day across 3 billing organizations.
- 78% of Medicaid dollars are on codes with a history of abuse.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 27.9 | 24.1 | 16.1 | 22.6 | 200 | 1 | 90791 90837 90847 | $59K |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 30.6 | 26.4 | 17.6 | 24.8 | 149 | 1 | 90837 90847 | $64K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 37.3 | 30.6 | 20.4 | 27.8 | 156 | 1 | 90837 90847 | $71K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 32.3 | 31.1 | 20.8 | 30.6 | 188 | 1 | 90837 90847 | $75K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 43.7 | 40.6 | 27.1 | 36.9 | 222 | 1 | 90791 90837 90847 | $95K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 58.8 | 42.6 | 28.4 | 38.3 | 214 | 1 | 90837 90847 | $103K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 58.0 | 31.2 | 20.8 | 30.7 | 227 | 1 | 90837 90847 | $75K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 43.3 | 32.8 | 21.9 | 30.6 | 199 | 1 | 90791 90837 90847 | $72K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 43.0 | 33.3 | 22.2 | 29.9 | 218 | 1 | 90791 90837 90847 | $81K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MERIDA AMARILIS VALERA, LPCA |
| Type | Individual |
| Status | Active |
| NPI issued | February 1, 2018, last updated May 16, 2024 |
| Practice location | 3333 BROOKVIEW HILLS BLVD STE 205, Winston Salem, NC 27103-5661, 814-218-2598 |
| Specialties | Counselor (101Y00000X, license A13699 NC) Counselor, Professional (101YP2500X, license 13699 NC) Counselor, Mental Health (101YM0800X, primary, license 13699 NC) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $1.8M | 78% | $319 | $191 (top 5% from $442) | 87th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $364K | 16% | $136 | $130 (top 5% from $458) | 53rd percentile | |
| 90791 | Psychiatric diagnostic evaluation | $136K | 6% | $149 | $105 (top 5% from $228) | 82nd percentile |
In this area
2 providers in Forsyth County, NC carry an indicator in the public record, with $5.5M at stake between them. The most common is named in an enforcement record, on 1 of them, followed by more hours than a day holds on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ULTIMATE SACRIFICE Winston Salem, NC, ranked 96 | $365K |
|
| 4 | UMALAKSHMI THOTAKURA Winston Salem, NC, ranked 7446 | $5.2M |
|
Recent enforcement in NC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.