Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SUMMIT BHC NEW JERSEY, LLC

NPI: 1174123582 · FRANKLIN, TN 37067 · Substance Abuse Rehabilitation Facility · NPI assigned 10/27/2020

Billing Flags · Automated signals — not evidence of fraud
Single-Code Concentration

97% of spending on code H0010 with only 2 total codes billed. Highly concentrated billing profile.

Entity Proliferation

Authorized official GILBERT, PAUL controls 15+ related entities in our dataset. Read more

$21.89M
Total Medicaid Paid
12,898
Total Claims
7,609
Beneficiaries
2
Codes Billed
2021-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGILBERT, PAUL (CHIEF LEGAL OFFICER)
NPI Enumeration Date10/27/2020

Related Entities

Other providers sharing the same authorized official: GILBERT, PAUL

ProviderCityStateTotal Paid
SUMMIT BHC HENRYVILLLE, LLC TERRE HAUTE IN $90.64M
SBH EL PASO, LLC ESPANOLA NM $42.30M
SAFE HARBOR BEHAVIORAL HEALTHCARE, LLC PORTSMOUTH VA $13.84M
SUMMIT BHC WEST VIRGINIA LLC CHARLESTON WV $5.14M
SBH COLORADO LLC COLORADO SPRINGS CO $4.78M
SBH-KINGSPORT KINGSPORT TN $4.00M
STRATEGIC BH-BROWNSVILLE LLC HARLINGEN TX $3.46M
SBH-WILMINGTON LLC LELAND NC $3.33M
SUMMIT BHC WEST VIRGINIA, LLC CHARLESTON WV $1.82M
SBH-GREEN BAY LLC GREEN BAY WI $1.36M
SBH-DAVENPORT, LLC BETTENDORF IA $230K
SBH-MADISON LLC MIDDLETON WI $140K
GARNER BEHAVIORAL HOSPITAL, LLC GARNER NC $131K
WILLIAMSBURG PROFESSIONAL SERVICES, INC. WILLIAMSBURG VA $91K
SUMMIT BHC MESA LLC MESA AZ $81K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 2,111 $3.69M
2022 3,621 $5.82M
2023 4,445 $7.76M
2024 2,721 $4.62M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0010 Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) 12,563 7,277 $21.16M
H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem 335 332 $730K