Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › NJ › Denville › NPI 1821469966
Clinic

Prime Healthcare Services - Saint Clare's LLC

Prime Healthcare Services - Saint Clare's LLC was paid $4.71M by Medicaid between Jan 2018 and Nov 2024, across 1 billing code. Its largest line is H0040, Assertive community treatment program, per diem — 100% of everything it billed.

33Billing provider infoPRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC
DENVILLE, NJ 07834
33aNPI1821469966assigned 10/15/2015
28Total paid$4.71M
24GClaims3,077
24DCodes billed1
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers

Next to other Adult Mental Health Clinic/Center providers in New Jersey

Rank by total paid#16 of 45
Median peer was paid$2.68M
This provider vs. median1.8×

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 Concentration100% of spending on code H0040 with only 1 total codes billed. Highly concentrated billing profile.
Box 24A · Dates of service

Paid by month

$0$25K$50K$75K2018201920202021202220232024
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
YearClaimsPaid
2018413$614K
2019404$601K
2020430$640K
2021462$687K
2022527$805K
2023500$801K
2024incomplete341$563K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
H0040 Assertive community treatment program, per diem 100% 3,077 3,077 $4.71M

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.

From NPPES

Who's on the registration

Authorized officialHEATHER, MICHAEL (CHIEF FINANCIAL OFFICER)
Same official

Other billing entities under HEATHER, MICHAEL

Full network →
ProviderLocationPaid
Prime Healthcare Services - Saint Clare's LLCDenville, NJ$90.22M
Prime Healthcare Services - Saint Clare's LLCBoonton Township, NJ$3.75M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.