Adult Foster Care of the North Shore, Inc.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T1028 (2 unique codes).
Consistent Billing
Monthly billing amounts show almost no natural variation (CV < 0.1).
Monthly billing coefficient of variation: 0.0688 (near-zero variation).
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
Consistent Billing
Consistent Billing means this provider's monthly billing amounts show almost no natural variation. Real medical practices tend to have some fluctuation in monthly billing, so unnaturally steady billing can indicate automated or fabricated claims.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Custodial Care Facility, Adult Care Home Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $60.6M is at the 50th percentile among 8 Custodial Care Facility, Adult Care Home providers.
Total Paid
$60.6M
$60,646,268
Total Claims
595K
Beneficiaries
29K
20.3 claims/patient
Avg Cost/Claim
$102
🔍 Analysis
Provider Overview
Adult Foster Care of the North Shore, Inc. is a Custodial Care Facility, Adult Care Home provider based in Gloucester, MA. From the 2018–2024 period, this provider received $60.6M in Medicaid payments across 595K claims.
Why This Matters
At $60.6M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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