Gichuki, Loice

Gichuki, Loice was paid $1.36M by Medicaid between Aug 2023 and Dec 2024, across 3 billing codes. Its largest line is 97153, applied behavior analysis (autism therapy), per 15 minutes — 92% of everything it billed.

33Billing provider infoGICHUKI, LOICE
SUTTON, MA 01590

33aNPI1316606858assigned 12/13/2021

33bProvider typeBehavioral Analyst

28Total paid$1.36M

24GClaims4,127

24DCodes billed3

24AFirst – last monthAug 2023 – Dec 2024

Compared with peers

Next to other Behavioral Analyst providers in Massachusetts

Rank by total paid#30 of 150

Median peer was paid$228K

This provider vs. median6.0×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration92% of spending on code 97153 with only 3 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2023	1,491	$500K
2024incomplete	2,636	$860K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
97153	Applied behavior analysis (autism therapy), per 15 minutesAdaptive behavior treatment by protocol, administered by technician, each 15 minutes	92%	3,325	207	$1.26M
H0031	Mental health assessment, by non-physician	5.1%	564	161	$69K
97155	Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes	2.4%	238	76	$33K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.