Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC

NPI: 1821469966 · DENVILLE, NJ 07834 · Adult Mental Health Clinic/Center · NPI assigned 10/15/2015

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

100% of spending on code H0040 with only 1 total codes billed. Highly concentrated billing profile.

$4.71M
Total Medicaid Paid
3,077
Total Claims
3,077
Beneficiaries
1
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialHEATHER, MICHAEL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date10/15/2015

Related Entities

Other providers sharing the same authorized official: HEATHER, MICHAEL

ProviderCityStateTotal Paid
PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC DENVILLE NJ $90.22M
PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC BOONTON TOWNSHIP NJ $3.75M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 413 $614K
2019 404 $601K
2020 430 $640K
2021 462 $687K
2022 527 $805K
2023 500 $801K
2024 341 $563K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0040 Assertive community treatment program, per diem 3,077 3,077 $4.71M