Providers

REX L MAHNENSMITH, M.D.

NPI 1760466528, individual, Waterbury, CT, Internal Medicine

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 20 months, but with up to 2731 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • Medicaid dollars per patient on code 95165 ($1117 per patient-month) sit in the top 5% of every provider billing that code.
score 56 of 100, rank 7445, $5.2M at stake

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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Nov 2018More hours than a day holds, even counting one unit per claim line29.452.134.747.41568399203 99204 99213 99214$186K
Dec 2018More hours than a day holds, even counting one unit per claim line26.447.331.546.61451399203 99204 99213 99214$174K
Jan 2019More hours than a day holds, even counting one unit per claim line32.958.539.052.61773399203 99204 99213 99214$213K
Feb 2019More hours than a day holds, even counting one unit per claim line34.260.340.256.31719399203 99204 99213 99214$199K
Mar 2019More hours than a day holds, even counting one unit per claim line32.057.138.056.21825399203 99204 99213 99214$206K
Apr 2019More hours than a day holds, even counting one unit per claim line30.154.136.149.21711399203 99204 99213 99214$188K
May 2019More hours than a day holds, even counting one unit per claim line33.960.640.454.51965299203 99204 99213 99214$221K
Jun 2019More hours than a day holds, even counting one unit per claim line29.452.635.152.61630299203 99204 99213 99214$184K
Jul 2019More hours than a day holds, even counting one unit per claim line29.052.435.047.11668299203 99204 99213 99214$190K
Aug 2019More hours than a day holds, even counting one unit per claim line26.747.731.844.81462299203 99204 99213 99214$174K
Sep 2019More hours than a day holds, even counting one unit per claim line35.964.442.961.31919299203 99204 99213 99214$228K
Oct 2019More hours than a day holds, even counting one unit per claim line37.868.645.761.62103299203 99204 99213 99214$249K
Nov 2019More hours than a day holds, even counting one unit per claim line35.162.141.459.11878299203 99204 99213 99214$219K
Dec 2019More hours than a day holds, even counting one unit per claim line31.656.337.552.91724299203 99204 99213 99214$207K
Jan 2020More hours than a day holds, even counting one unit per claim line50.586.757.877.92684199203 99204 99213 99214$335K
Feb 2020More hours than a day holds, even counting one unit per claim line56.799.466.396.12731199203 99204 99213 99214$359K
Mar 2020More hours than a day holds, even counting one unit per claim line36.867.244.863.11981199203 99204 99213 99214$258K
Apr 2020More hours than a day holds, even counting one unit per claim line32.357.738.452.41785199203 99204 99213 99214 99441 99442$217K
May 2020More hours than a day holds, even counting one unit per claim line42.967.545.066.52320199203 99204 99213 99214 99441 99442$262K
Jun 2020More hours than a day holds, even counting one unit per claim line26.745.130.141.01578199203 99204 99213 99214 99442$168K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameREX L MAHNENSMITH, M.D.
TypeIndividual
StatusActive
NPI issuedDecember 5, 2005, last updated October 22, 2015
Practice location80 PHOENIX AVE, Waterbury, CT 06702-1418, 203-756-8021
Specialties
Internal Medicine, Nephrology (207RN0300X, license 021731 CT)
Internal Medicine (207R00000X, primary, license 021731 CT)

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.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$2.5M30%$113$60 (top 5% from $133)91st percentile
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$1.6M18%$167$95 (top 5% from $171)94th percentile
95165Professional service for preparation and provision of 1 or more antigens$1.5M18%$1K$187 (top 5% from $1K)96th percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$1.3M15%$74$44 (top 5% from $110)85th percentile
99203New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$600K7%$100$67 (top 5% from $121)88th percentile
95004Test for allergy using allergenic extract$200K2%$185$136 (top 5% from $315)71st percentile
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus$141K2%$34$32 (top 5% from $49)57th percentile
0241URespiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected$86K1%$117$113 (top 5% from $189)53rd percentile
Medicare Part B 2024, largest codes
codewhat it isservicesbeneficiariespaidsubmitted per serviceallowed per servicecharge to allowedusual for this code
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3535$5K$250$1291.9x2.3x (90th percentile 4.1x)
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more4527$4K$350$1302.7x2.3x (90th percentile 3.8x)
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more4834$3K$247$922.7x2.2x (90th percentile 3.8x)
G0444Annual depression screening, 5 to 15 minutes1818$342$30$191.6x2.2x (90th percentile 3.8x)
96127Assessment of emotional or behavioral problems2213$65$40$58.1x3.7x (90th percentile 7.2x)

A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.

In this area

30 providers in Waterbury, CT carry an indicator in the public record, with $12.6M at stake between them. The most common is part of a provider network, on 12 of them, followed by more hours than a day holds on 11. 4 are tier 1: documented action, then payment.

tierproviderat stakewhy
1KATRIN MOSKOWITZ
Waterbury, CT, ranked 169
$63K
  • Listed on the Medicare revocation list since September 24, 2020.
  • Medicaid still paid claims in 34 later months, $63,386 in total.
1ANATOLY BRAYLOVSKY
Wallingford, CT, ranked 488
$0
  • Adjudicated (sentenced) per a Department of Justice release dated May 22, 2024.
  • No Medicaid payments in the last 12 observed months.
1FAMILY PRACTICE OF GREATER NEW HAVEN, LLC
Wallingford, CT, ranked 514
$0
  • Adjudicated (sentenced) per a Department of Justice release dated May 22, 2024.
  • No Medicaid payments in the last 12 observed months.
1LP COUNSELING SERVICES, LLC
North Haven, CT, ranked 673
$0
  • Adjudicated (sentenced, pleaded guilty) per a Department of Justice release dated August 6, 2024.
  • No Medicaid payments in the last 12 observed months.
3TOTALITY HOME HEALTH CARE AGENCY, LLC
Milford, CT, ranked 779
$2.3M
  • Part of provider network D1-00091, ranked 91 nationally.
  • Medicaid dollars per patient on code T1502 ($1331 per patient-month) sit in the top 5% of every provider billing that code.
3WHITNEY MANOR OPERATING COMPANY LLC
Hamden, CT, ranked 1451
$35K
  • Part of provider network D1-00091, ranked 91 nationally.
3ADVANCED CENTER FOR NURSING & REHABILITATION LLC
New Haven, CT, ranked 1471
$27K
  • Part of provider network D1-00091, ranked 91 nationally.
3NEW HAVEN CENTER FOR NURSING & REHABILITATION, LLC
New Haven, CT, ranked 1479
$24K
  • Part of provider network D1-00091, ranked 91 nationally.
All 30 in CT

Recent enforcement in CT

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementJun 23, 2026
Connecticut Lab and its Owner Pay Over $145K to Settle Allegations of Medicaid Enrollment Fraud
Coastal Diagnostics and its owner made material misrepresentations in a Connecticut Medicaid Provider Enrollment Application by denying any relationship to another enrolled provider, Genco Lab, and then submitted claims for laboratory services.
DOJPleaded guiltyJun 23, 2026
Middletown Man Pleads Guilty to Operating Unlawful Money Transmitting Business
Habib registered a company and opened a bank account through which fraudulent claims were submitted to Medicare Advantage plans for durable medical equipment, including orthotics and braces, that beneficiaries did not request, consent to, or receive, and he wired proceeds to Pakistan without a money transmitting license.
DOJComplaint filedMay 22, 2026
APRN Charged with Defrauding Connecticut’s Medicaid Program
An APRN was charged with submitting fraudulent Medicaid claims for medication management services that were not provided, including for patients who had stopped seeing her or who were hospitalized, incarcerated, or deceased.
DOJSentencedApr 30, 2026
Cheshire Nurse Who Illegally Distributed Controlled Substances is Sentenced
An Advanced Practice Registered Nurse enrolled as a Medicare and Medicaid provider unlawfully distributed amphetamines and benzodiazepines to individuals without legitimate medical need, charging $200 cash for office visits, and Medicaid paid $287.58 for prescriptions written for an undercover agent.
DOJSentencedFeb 10, 2026
Bloomfield Man Sentenced to Federal Prison for Health Care Fraud
Tyson and Epps submitted fraudulent Medicaid claims for psychotherapy counseling sessions that were not provided, billed under Tyson's provider number for services purportedly provided by the suspended Epps, and Tyson provided fraudulent patient records during a Medicaid audit.

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.

Ask this case

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