Is HABIT OPCO, LLC flagged for Medicaid fraud?

HABIT OPCO, LLC (NPI: 1912155516) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does HABIT OPCO, LLC bill Medicaid?

HABIT OPCO, LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinic/Center, Methadone Clinic provider. Located in BRATTLEBORO, VT.

What is NPI 1912155516?

NPI 1912155516 is the National Provider Identifier for HABIT OPCO, LLC. They are a Clinic/Center, Methadone Clinic provider based in BRATTLEBORO, VT. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

HABIT OPCO, LLC

Clinic/Center, Methadone Clinic·BRATTLEBORO, VT·NPI: 1912155516Share

Compared to Clinic/Center, Methadone Clinic Peers

Total spending distribution among 5 providers in this specialty

P25MedianP75P90

This provider's total spending of $93.2M is at the 50th percentile among 5 Clinic/Center, Methadone Clinic providers.

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

Total Paid

$93.2M

$93,156,915

Total Claims

3.6M

Beneficiaries

238K

15.1 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018

$10.3M

-4%

2019

$10.0M

+6%

2020

$10.6M

+6%

2021

$11.2M

+14%

2022

$12.8M

+72%

2023

$22.0M

-26%

2024

$16.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 10 distinct procedure codes. The top code (H0020 (Alcohol/drug services; methadone administration)) accounts for 60% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0020Alcohol/drug services; methadone administrationSee all providers →

$55.8M

3.3M claims

$16.76

$18.95

0.9×

Normal range

H0020Normal range

Alcohol/drug services; methadone administration

$55.8M

3.3M claims · 59.9%

Your Cost: $16.76/claim|Median: $18.95

0.9× median

G2067Medication-assisted treatment, opioid use disorder, per monthSee all providers →

$32.5M

171K claims

$190.73

$73.29

2.6×

Top 25%

G2067Top 25%

Medication-assisted treatment, opioid use disorder, per month

$32.5M

171K claims · 34.9%

Your Cost: $190.73/claim|Median: $73.29

2.6× median

G2078 See all providers →

$1.9M

55K claims

$35.27

$27.04

1.3×

Normal range

G2078Normal range

$1.9M

55K claims · 2.1%

Your Cost: $35.27/claim|Median: $27.04

1.3× median

G2074 See all providers →

$1.7M

11K claims

$149.16

$82.20

1.8×

Top 25%

G2074Top 25%

$1.7M

11K claims · 1.8%

Your Cost: $149.16/claim|Median: $82.20

1.8× median

G2076 See all providers →

$657K

3,968 claims

$165.69

$275.92

0.6×

Normal range

G2076Normal range

$657K

3,968 claims · 0.7%

Your Cost: $165.69/claim|Median: $275.92

0.6× median

90791Psychiatric diagnostic evaluationSee all providers →

$290K

2,390 claims

$121.51

$99.21

1.2×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$290K

2,390 claims · 0.3%

Your Cost: $121.51/claim|Median: $99.21

1.2× median

H2015Comprehensive community support services, per 15 minSee all providers →

$182K

14K claims

$12.74

$96.24

0.1×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$182K

14K claims · 0.2%

Your Cost: $12.74/claim|Median: $96.24

0.1× median

H2016Comprehensive community support services, per 15 minSee all providers →

$22K

177 claims

$121.87

$321.53

0.4×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$22K

177 claims · 0.0%

Your Cost: $121.87/claim|Median: $321.53

0.4× median

99212Office/outpatient visit, low complexitySee all providers →

$4K

88 claims

$50.21

$25.06

2.0×

Top 25%

99212Top 25%

Office/outpatient visit, low complexity

$4K

88 claims · 0.0%

Your Cost: $50.21/claim|Median: $25.06

2.0× median

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

$1K

17 claims

$73.48

$74.63

1.0×

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

$1K

17 claims · 0.0%

Your Cost: $73.48/claim|Median: $74.63

1.0× median

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