Is JAMES L MAHER CENTER flagged for Medicaid fraud?

JAMES L MAHER CENTER (NPI: 1558492405) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does JAMES L MAHER CENTER bill Medicaid?

JAMES L MAHER CENTER received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinic/Center, Multi-Specialty provider. Located in NEWPORT, RI.

What is NPI 1558492405?

NPI 1558492405 is the National Provider Identifier for JAMES L MAHER CENTER. They are a Clinic/Center, Multi-Specialty provider based in NEWPORT, RI. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

JAMES L MAHER CENTER

Clinic/Center, Multi-Specialty·NEWPORT, RI·NPI: 1558492405Share

Compared to Clinic/Center, Multi-Specialty Peers

Total spending distribution among 12 providers in this specialty

P25MedianP75P90

This provider's total spending of $52.5M is at the 25th percentile among 12 Clinic/Center, Multi-Specialty providers.

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

Total Paid

$52.5M

$52,475,861

Total Claims

99K

Beneficiaries

37K

2.7 claims/patient

Avg Cost/Claim

$528

Monthly Spending Trend

Yearly Spending

2018

$7.0M

-3%

2019

$6.8M

-12%

2020

$6.0M

+12%

2021

$6.7M

+12%

2022

$7.5M

+23%

2023

$9.2M

+0%

2024

$9.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T2033 (Residential care, NOS; per diem)) accounts for 61% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2033Residential care, NOS; per diemSee all providers →

$32.1M

8,689 claims

$3,691.09

$1,051.57

3.5×

Top 25%

T2033Top 25%

Residential care, NOS; per diem

$32.1M

8,689 claims · 61.1%

Your Cost: $3,691.09/claim|Median: $1,051.57

3.5× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$10.9M

36K claims

$301.75

$150.51

2.0×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$10.9M

36K claims · 20.8%

Your Cost: $301.75/claim|Median: $150.51

2.0× median

T2017Habilitation, residential, waiver; 15 minSee all providers →

$4.0M

16K claims

$242.47

$137.32

1.8×

Normal range

T2017Normal range

Habilitation, residential, waiver; 15 min

$4.0M

16K claims · 7.6%

Your Cost: $242.47/claim|Median: $137.32

1.8× median

T2003Non-emergency transport; encounter/tripSee all providers →

$3.3M

24K claims

$137.03

$21.70

6.3×

Top 10%

T2003Top 10%

Non-emergency transport; encounter/trip

$3.3M

24K claims · 6.2%

Your Cost: $137.03/claim|Median: $21.70

6.3× median

T2022Case management, per monthSee all providers →

$1.1M

7,692 claims

$148.33

$202.77

0.7×

Normal range

T2022Normal range

Case management, per month

$1.1M

7,692 claims · 2.2%

Your Cost: $148.33/claim|Median: $202.77

0.7× median

T2023Community transition, waiver; per serviceSee all providers →

$558K

2,443 claims

$228.42

$300.13

0.8×

Normal range

T2023Normal range

Community transition, waiver; per service

$558K

2,443 claims · 1.1%

Your Cost: $228.42/claim|Median: $300.13

0.8× median

T2019Habilitation, prevocational, waiver; per 15 minSee all providers →

$427K

2,652 claims

$161.14

$88.91

1.8×

Normal range

T2019Normal range

Habilitation, prevocational, waiver; per 15 min

$427K

2,652 claims · 0.8%

Your Cost: $161.14/claim|Median: $88.91

1.8× median

T2015Habilitation, prevocational, waiver, per diemSee all providers →

$48K

156 claims

$306.95

$88.27

3.5×

Normal range

T2015Normal range

Habilitation, prevocational, waiver, per diem

$48K

156 claims · 0.1%

Your Cost: $306.95/claim|Median: $88.27

3.5× median

T2025Waiver services, NOS; per 15 minSee all providers →

$36K

379 claims

$95.49

$124.39

0.8×

Normal range

T2025Normal range

Waiver services, NOS; per 15 min

$36K

379 claims · 0.1%

Your Cost: $95.49/claim|Median: $124.39

0.8× median

T2020Day habilitation, waiver; per diemSee all providers →

$21K

413 claims

$51.34

$87.34

0.6×

Normal range

T2020Normal range

Day habilitation, waiver; per diem

$21K

413 claims · 0.0%

Your Cost: $51.34/claim|Median: $87.34

0.6× median

T1002RN services, per 15 minutesSee all providers →

$18K

282 claims

$62.97

$37.42

1.7×

Normal range

T1002Normal range

RN services, per 15 minutes

$18K

282 claims · 0.0%

Your Cost: $62.97/claim|Median: $37.42

1.7× median

T2013Habilitation, residential, waiver, per hourSee all providers →

223 claims

$0.00

$158.23

—

Normal range

T2013Normal range

Habilitation, residential, waiver, per hour

223 claims · 0.0%

Your Cost: $0.00/claim|Median: $158.23

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