Gore, John

Gore, John was paid $17.35M by Medicaid between Jan 2018 and Dec 2024, across 3 billing codes. Its largest line is H0036, community psychiatric support and treatment, per 15 minutes — 93% of everything it billed.

33Billing provider infoGORE, JOHN
SOUTH PLAINFIELD, NJ 07080

33aNPI1619337482assigned 03/07/2016

33bProvider typeAddiction (Substance Use Disorder) Counselor

28Total paid$17.35M

24GClaims89,831

24DCodes billed3

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Addiction (Substance Use Disorder) Counselor providers in New Jersey

Rank by total paid#2 of 35

Median peer was paid$398K

This provider vs. median44×

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 Concentration93% of spending on code H0036 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
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
2024incomplete	11,269	$2.34M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0036	Community psychiatric support and treatment, per 15 minutesCommunity psychiatric supportive treatment, face-to-face, per 15 minutes	93%	77,905	27,216	$16.06M
H2014	Skills training and development, per 15 minutes	7.4%	11,913	4,317	$1.28M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	<1%	13	13	$4K

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.