Medicaid Provider Spending

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

GORE, JOHN

NPI: 1619337482 · SOUTH PLAINFIELD, NJ 07080 · Addiction (Substance Use Disorder) Counselor · NPI assigned 03/07/2016

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

93% of spending on code H0036 with only 3 total codes billed. Highly concentrated billing profile.

$17.35M
Total Medicaid Paid
89,831
Total Claims
31,546
Beneficiaries
3
Codes Billed
2018-01
First Month
2024-12
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 6,519 $1.32M
2019 11,827 $2.28M
2020 16,322 $2.76M
2021 13,651 $2.78M
2022 16,372 $3.15M
2023 13,871 $2.72M
2024 11,269 $2.34M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes 77,905 27,216 $16.06M
H2014 Skills training and development, per 15 minutes 11,913 4,317 $1.28M
H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem 13 13 $4K