Is EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. flagged for Medicaid fraud?

EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. (NPI: 1477646081) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. bill Medicaid?

EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in RALEIGH, NC.

What is NPI 1477646081?

NPI 1477646081 is the National Provider Identifier for EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.. They are a Community/Behavioral Health provider based in RALEIGH, NC. This NPI is registered with the CMS NPI Registry.

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EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

Community/Behavioral Health·RALEIGH, NC·NPI: 1477646081Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $29.3M is at the 25th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$29.3M

$29,299,573

Total Claims

263K

Beneficiaries

24K

11.1 claims/patient

Avg Cost/Claim

$112

Monthly Spending Trend

Yearly Spending

2018

$6.7M

-15%

2019

$5.6M

-11%

2020

$5.0M

-15%

2021

$4.3M

-55%

2022

$1.9M

+86%

2023

$3.6M

-40%

2024

$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T2013 (Habilitation, residential, waiver, per hour)) accounts for 55% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2013Habilitation, residential, waiver, per hourSee all providers →

$16.1M

128K claims

$125.95

$158.23

0.8×

Normal range

T2013Normal range

Habilitation, residential, waiver, per hour

$16.1M

128K claims · 55.0%

Your Cost: $125.95/claim|Median: $158.23

0.8× median

T2012Habilitation, educational; per 15 minSee all providers →

$3.6M

25K claims

$145.10

$177.54

0.8×

Normal range

T2012Normal range

Habilitation, educational; per 15 min

$3.6M

25K claims · 12.3%

Your Cost: $145.10/claim|Median: $177.54

0.8× median

H0045Respite care services, not in the home, per diemSee all providers →

$2.9M

35K claims

$80.83

$119.19

0.7×

Normal range

H0045Normal range

Respite care services, not in the home, per diem

$2.9M

35K claims · 9.8%

Your Cost: $80.83/claim|Median: $119.19

0.7× median

S5150Unskilled respite care, per 15 minSee all providers →

$1.9M

27K claims

$70.53

$84.46

0.8×

Normal range

S5150Normal range

Unskilled respite care, per 15 min

$1.9M

27K claims · 6.4%

Your Cost: $70.53/claim|Median: $84.46

0.8× median

H2015Comprehensive community support services, per 15 minSee all providers →

$1.7M

17K claims

$98.07

$96.24

1.0×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$1.7M

17K claims · 5.8%

Your Cost: $98.07/claim|Median: $96.24

1.0× median

H2025Ongoing support to maintain employment, per 15 minSee all providers →

$1.1M

11K claims

$97.60

$100.49

1.0×

Normal range

H2025Normal range

Ongoing support to maintain employment, per 15 min

$1.1M

11K claims · 3.7%

Your Cost: $97.60/claim|Median: $100.49

1.0× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$750K

10K claims

$74.25

$150.51

0.5×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$750K

10K claims · 2.6%

Your Cost: $74.25/claim|Median: $150.51

0.5× median

T2020Day habilitation, waiver; per diemSee all providers →

$612K

1,799 claims

$340.42

$87.34

3.9×

Top 10%

T2020Top 10%

Day habilitation, waiver; per diem

$612K

1,799 claims · 2.1%

Your Cost: $340.42/claim|Median: $87.34

3.9× median

T2041Supports brokerage, self-directed; per 15 minSee all providers →

$499K

3,179 claims

$157.12

$162.29

1.0×

Normal range

T2041Normal range

Supports brokerage, self-directed; per 15 min

$499K

3,179 claims · 1.7%

Your Cost: $157.12/claim|Median: $162.29

1.0× median

H2026 See all providers →

$209K

3,131 claims

$66.79

$76.18

0.9×

Normal range

H2026Normal range

$209K

3,131 claims · 0.7%

Your Cost: $66.79/claim|Median: $76.18

0.9× median

T1016Case management, each 15 minSee all providers →

$4K

238 claims

$15.63

$49.62

0.3×

Normal range

T1016Normal range

Case management, each 15 min

$4K

238 claims · 0.0%

Your Cost: $15.63/claim|Median: $49.62

0.3× median

YP710 See all providers →

997 claims

$0.00

—

YP710

997 claims · 0.0%

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