Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $248.05 per claim for T1002 (RN services, per 15 minutes), which is 6.6× the national median of $37.42.
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $248.05 per claim for T1002 (RN services, per 15 minutes) — 6.6× the national median of $37.42.
Bills $232.44 per claim for T1003 (LPN/LVN services, per 15 minutes) — 9.6× the national median of $24.24.
Bills $352.46 per claim for T1004 (Services of a qualified nursing aide, per 15 minutes) — 7.0× the national median of $50.30.
Billing in the top 1% nationally for 1 procedure code: T1004.
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $62.8M is at the below 25th percentile among 322 Home Health providers.
Total Paid
$62.8M
$62,757,861
Total Claims
0
Beneficiaries
0
Avg Cost/Claim
$0
🔍 Analysis
Provider Overview
Northeast Arc INC is a Home Health provider based in Danvers, MA. From the 2018–2024 period, this provider received $0 in Medicaid payments across 0 claims.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 8 distinct procedure codes. The top code (T1002 (RN services, per 15 minutes)) accounts for 100% of total spending.
RN services, per 15 minutes
$62.8M
253K claims · 100.0%
LPN/LVN services, per 15 minutes
$25.4M
109K claims · 40.5%
$1.6M
4,562 claims
$352.46
$50.30
Services of a qualified nursing aide, per 15 minutes
$1.6M
4,562 claims · 2.6%
$1.0M
1,071 claims
$977.98
$85.62
Nursing care, in the home, by RN, per diem
$1.0M
1,071 claims · 1.7%
$79K
1,545 claims
$51.06
$51.67
Skilled nursing services, home health, per visit, RN
$79K
1,545 claims · 0.1%
$673
49 claims
$13.73
$33.85
COVID-19 vaccine admin, Moderna, 2nd dose
$673
49 claims · 0.0%
$474
68 claims
$6.98
$25.93
COVID-19 vaccine admin, Moderna, 1st dose
$474
68 claims · 0.0%
COVID-19 vaccine (Moderna), first dose
$0
117 claims · 0.0%
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