Ma-department of Social Services-rehab
Public Health or Welfare
Boston, Massachusetts
NPI: 1073730347
Risk Tier
High
Total Paid
$490.7M
$490,725,903
Total Claims
226K
Beneficiaries
106K
Avg Cost/Claim
$2,173.52
Active billing period: 80 months (2018-01 to 2024-08)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $2,173.52 per claim for H0018 (Behavioral health; short-term residential, per diem), which is 4.6× the national median of $467.51.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code H0018 (1 unique codes).
Advanced Detection Signals
Suspicious Concentration
Herfindahl-Hirschman Index of 1 across 1 procedure codes — billing is highly concentrated in very few services.
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