SEAN ELDER, APRN
NPI 1770997926, individual, Las Vegas, NV, Nurse Practitioner, Psych/Mental Health
- Billed more hands-on hours than a day holds in 5 months, peaking at 13.0 hours per day across 3 billing organizations.
- Medicaid dollars per patient on code 99214 ($333 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 25.8 | 17.4 | 11.6 | 16.4 | 179 | 2 | 90833 90876 99213 99214 | $67K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 39.5 | 19.5 | 13.0 | 19.2 | 107 | 1 | 90876 99214 | $72K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 41.8 | 19.5 | 13.0 | 17.5 | 111 | 1 | 90876 99214 | $72K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 37.5 | 14.0 | 9.3 | 13.3 | 103 | 1 | 90876 99214 | $50K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 28.8 | 8.4 | 5.6 | 7.9 | 83 | 1 | 90876 99214 | $32K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SEAN ELDER, APRN |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | June 16, 2014, last updated October 8, 2020 |
| Practice location | 6161 W CHARLESTON BLVD, Las Vegas, NV 89146-1126, 702-486-0452 |
| Mailing address | 1045 NEVADA SKY ST, Las Vegas, NV 89128-2129 |
| Specialties | Specialist/Technologist, Other, Electroneurodiagnostic (246ZE0600X) Nurse Practitioner, Psych/Mental Health (363LP0808X, primary, license APRN001702 NV) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $479K | 25% | $167 | $44 (top 5% from $110) | 98th percentile | |
| 90876 | Psychophysiological therapy with biofeedback 45 min | $295K | 16% | $557 | $392 (top 5% from $816) | 74th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $293K | 15% | $333 | $60 (top 5% from $133) | 100th percentile | |
| 95984 | Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional | $254K | 13% | $427 | too few months to rank | ||
| 95700 | Measurement of brain wave activity (eeg), continuous | $218K | 12% | $358 | $184 (top 5% from $586) | 87th percentile | |
| 95983 | Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional | $101K | 5% | $167 | too few months to rank | ||
| Q3014 | Telehealth originating site facility fee | $87K | 5% | $170 | $21 (top 5% from $84) | 98th percentile | |
| 90901 | Biofeedback training | $69K | 4% | $208 | $45 (top 5% from $503) | 75th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 45 | 16 | $3K | $199 | $83 | 2.4x | 2.3x (90th percentile 3.8x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 44 | 16 | $2K | $125 | $52 | 2.4x | 2.1x (90th percentile 3.5x) |
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
338 providers in Clark County, NV carry an indicator in the public record, with $275.8M at stake between them. The most common is part of a provider network, on 167 of them, followed by more hours than a day holds on 151. 17 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | TIMOTHY WILSON Las Vegas, NV, ranked 113 | $192K |
|
| 1 | DEVONTE' CHRISTOPHER North Las Vegas, NV, ranked 175 | $59K |
|
| 1 | MANE SHAH Las Vegas, NV, ranked 205 | $40K |
|
| 1 | JOHN MARIUS TOLENTINO Las Vegas, NV, ranked 254 | $16K |
|
| 1 | DAVID ADAMS Las Vegas, NV, ranked 345 | $3K |
|
| 1 | VICTOR BRUCE Las Vegas, NV, ranked 361 | $2K |
|
| 1 | AMARA MEDICAL CENTER LLC Las Vegas, NV, ranked 457 | $9 |
|
| 1 | RODNESHIA CARTER North Las Vegas, NV, ranked 479 | $0 |
|
Recent enforcement in NV
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.