Medicaid Provider Spending

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

GICHUKI, LOICE

NPI: 1316606858 · SUTTON, MA 01590 · Behavioral Analyst · NPI assigned 12/13/2021

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

92% of spending on code 97153 with only 3 total codes billed. Highly concentrated billing profile.

$1.36M
Total Medicaid Paid
4,127
Total Claims
444
Beneficiaries
3
Codes Billed
2023-08
First Month
2024-12
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 1,491 $500K
2024 2,636 $860K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes 3,325 207 $1.26M
H0031 Mental health assessment, by non-physician 564 161 $69K
97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes 238 76 $33K