Is STONINGTON BEHAVIORAL HEALTH INC flagged for Medicaid fraud?

STONINGTON BEHAVIORAL HEALTH INC (NPI: 1225097231) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does STONINGTON BEHAVIORAL HEALTH INC bill Medicaid?

STONINGTON BEHAVIORAL HEALTH INC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Psychiatric Hospital provider. Located in NORTH STONINGTON, CT.

What is NPI 1225097231?

NPI 1225097231 is the National Provider Identifier for STONINGTON BEHAVIORAL HEALTH INC. They are a Psychiatric Hospital provider based in NORTH STONINGTON, CT. This NPI is registered with the CMS NPI Registry.

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STONINGTON BEHAVIORAL HEALTH INC

Psychiatric Hospital·NORTH STONINGTON, CT·NPI: 1225097231Share

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$50.9M

$50,944,638

Total Claims

323K

Beneficiaries

43K

7.5 claims/patient

Avg Cost/Claim

$158

Monthly Spending Trend

Yearly Spending

2018

$6.5M

+2%

2019

$6.6M

-38%

2020

$4.1M

+11%

2021

$4.6M

+67%

2022

$7.7M

+46%

2023

$11.3M

-11%

2024

$10.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (H0015 (Alcohol and/or drug abuse, intensive outpatient, per hour)) accounts for 57% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0015Alcohol and/or drug abuse, intensive outpatient, per hourSee all providers →

$29.0M

209K claims

$139.08

$129.75

1.1×

Normal range

H0015Normal range

Alcohol and/or drug abuse, intensive outpatient, per hour

$29.0M

209K claims · 57.0%

Your Cost: $139.08/claim|Median: $129.75

1.1× median

H2013Psychiatric health facility service, per diemSee all providers →

$11.6M

76K claims

$153.81

$841.93

0.2×

Normal range

H2013Normal range

Psychiatric health facility service, per diem

$11.6M

76K claims · 22.9%

Your Cost: $153.81/claim|Median: $841.93

0.2× median

H0011Alcohol and/or drug services, acute detoxification, per diemSee all providers →

$9.0M

22K claims

$413.65

$317.54

1.3×

Top 25%

H0011Top 25%

Alcohol and/or drug services, acute detoxification, per diem

$9.0M

22K claims · 17.7%

Your Cost: $413.65/claim|Median: $317.54

1.3× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$727K

11K claims

$66.67

$37.81

1.8×

Top 25%

99213Top 25%

Office/outpatient visit, est. patient, low-mod complexity

$727K

11K claims · 1.4%

Your Cost: $66.67/claim|Median: $37.81

1.8× median

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

$446K

2,996 claims

$149.03

$84.03

1.8×

Top 10%

99204Top 10%

Office/outpatient visit, new patient, mod-high complexity

$446K

2,996 claims · 0.9%

Your Cost: $149.03/claim|Median: $84.03

1.8× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$30K

635 claims

$47.75

$40.11

1.2×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$30K

635 claims · 0.1%

Your Cost: $47.75/claim|Median: $40.11

1.2× median

99212Office/outpatient visit, low complexitySee all providers →

$30K

973 claims

$30.40

$25.06

1.2×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$30K

973 claims · 0.1%

Your Cost: $30.40/claim|Median: $25.06

1.2× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$25K

247 claims

$99.89

$53.41

1.9×

Top 10%

99214Top 10%

Office/outpatient visit, est. patient, mod-high complexity

$25K

247 claims · 0.0%

Your Cost: $99.89/claim|Median: $53.41

1.9× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$16K

205 claims

$77.50

$57.85

1.3×

Normal range

99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$16K

205 claims · 0.0%

Your Cost: $77.50/claim|Median: $57.85

1.3× median

99211Office/outpatient visit, minimal complexitySee all providers →

$1K

86 claims

$16.66

$12.93

1.3×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$1K

86 claims · 0.0%

Your Cost: $16.66/claim|Median: $12.93

1.3× median

H0047Alcohol and/or drug abuse, not otherwise specifiedSee all providers →

901 claims

$0.00

$81.37

—

Normal range

H0047Normal range

Alcohol and/or drug abuse, not otherwise specified

901 claims · 0.0%

Your Cost: $0.00/claim|Median: $81.37

H0035Mental health partial hospitalization, treatment, per hourSee all providers →

24 claims

$0.00

$148.53

—

Normal range

H0035Normal range

Mental health partial hospitalization, treatment, per hour

24 claims · 0.0%

Your Cost: $0.00/claim|Median: $148.53

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