Is EASTER SEALS UCP NC & VA, INC. flagged for Medicaid fraud?

EASTER SEALS UCP NC & VA, INC. (NPI: 1770637407) 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 NC & VA, INC. bill Medicaid?

EASTER SEALS UCP NC & VA, 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 GREENVILLE, NC.

What is NPI 1770637407?

NPI 1770637407 is the National Provider Identifier for EASTER SEALS UCP NC & VA, INC.. They are a Community/Behavioral Health provider based in GREENVILLE, NC. This NPI is registered with the CMS NPI Registry.

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EASTER SEALS UCP NC & VA, INC.

Community/Behavioral Health·GREENVILLE, NC·NPI: 1770637407Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $38.7M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$38.7M

$38,729,666

Total Claims

282K

Beneficiaries

23K

12.4 claims/patient

Avg Cost/Claim

$137

Monthly Spending Trend

Yearly Spending

2018

$2.9M

+43%

2019

$4.1M

+30%

2020

$5.3M

-10%

2021

$4.8M

+34%

2022

$6.4M

+6%

2023

$6.8M

+25%

2024

$8.5M

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 33% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2013Habilitation, residential, waiver, per hourSee all providers →

$12.8M

84K claims

$152.58

$158.23

1.0×

Normal range

T2013Normal range

Habilitation, residential, waiver, per hour

$12.8M

84K claims · 33.1%

Your Cost: $152.58/claim|Median: $158.23

1.0× median

H2022Community-based wrap-around services, per diemSee all providers →

$6.8M

11K claims

$628.13

$336.31

1.9×

Normal range

H2022Normal range

Community-based wrap-around services, per diem

$6.8M

11K claims · 17.6%

Your Cost: $628.13/claim|Median: $336.31

1.9× median

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

$6.1M

73K claims

$83.14

$119.19

0.7×

Normal range

H0045Normal range

Respite care services, not in the home, per diem

$6.1M

73K claims · 15.7%

Your Cost: $83.14/claim|Median: $119.19

0.7× median

T2012Habilitation, educational; per 15 minSee all providers →

$6.0M

35K claims

$170.56

$177.54

1.0×

Normal range

T2012Normal range

Habilitation, educational; per 15 min

$6.0M

35K claims · 15.4%

Your Cost: $170.56/claim|Median: $177.54

1.0× median

S5145Foster care, therapeutic, child, per diemSee all providers →

$2.2M

21K claims

$105.36

$216.31

0.5×

Normal range

S5145Normal range

Foster care, therapeutic, child, per diem

$2.2M

21K claims · 5.7%

Your Cost: $105.36/claim|Median: $216.31

0.5× median

S5150Unskilled respite care, per 15 minSee all providers →

$1.7M

13K claims

$123.00

$84.46

1.5×

Normal range

S5150Normal range

Unskilled respite care, per 15 min

$1.7M

13K claims · 4.3%

Your Cost: $123.00/claim|Median: $84.46

1.5× median

H2015Comprehensive community support services, per 15 minSee all providers →

$1.1M

14K claims

$80.22

$96.24

0.8×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$1.1M

14K claims · 2.9%

Your Cost: $80.22/claim|Median: $96.24

0.8× median

H2023Supported employment, per 15 minSee all providers →

$797K

7,018 claims

$113.62

$103.94

1.1×

Normal range

H2023Normal range

Supported employment, per 15 min

$797K

7,018 claims · 2.1%

Your Cost: $113.62/claim|Median: $103.94

1.1× median

H2026 See all providers →

$741K

21K claims

$36.05

$76.18

0.5×

Normal range

H2026Normal range

$741K

21K claims · 1.9%

Your Cost: $36.05/claim|Median: $76.18

0.5× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$326K

2,091 claims

$155.81

$150.51

1.0×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$326K

2,091 claims · 0.8%

Your Cost: $155.81/claim|Median: $150.51

1.0× median

H2033Multisystemic therapy for juveniles, per 15 minutesSee all providers →

$165K

441 claims

$374.16

$227.82

1.6×

Top 25%

H2033Top 25%

Multisystemic therapy for juveniles, per 15 minutes

$165K

441 claims · 0.4%

Your Cost: $374.16/claim|Median: $227.82

1.6× median

T1017Targeted case management, per 15 minSee all providers →

$24K

88 claims

$268.26

$69.56

3.9×

Top 10%

T1017Top 10%

Targeted case management, per 15 min

$24K

88 claims · 0.1%

Your Cost: $268.26/claim|Median: $69.56

3.9× median

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