Northwestern Counseling & Support Services
Community/Behavioral Health
Saint Albans, Vermont
NPI: 1780708263
Risk Tier
Critical
Total Paid
$129.7M
$129,734,549
Total Claims
587K
Beneficiaries
53K
Avg Cost/Claim
$220.97
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (3)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $6,259.25 per claim for 99199 (Unlisted special service, procedure, or report), which is 1161.3× the national median of $5.39.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
High Claims Per Patient
Filing an unusually high number of claims per beneficiary compared to peers.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024