Habit Opco, LLC
Case Management
Springfield, Massachusetts
NPI: 1023175072
Risk Tier
Elevated
Total Paid
$224.1M
$224,149,167
Total Claims
9.6M
Beneficiaries
845K
Avg Cost/Claim
$23.26
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: 99211 at 4.8× median, 99213 at 1.9× median.
Advanced Detection Signals
Billing Velocity
5214.0 claims per working day — may exceed physically possible volume for a single provider.
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