Creative Works
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $6,541.04 per claim for T2016 (Habilitation, residential, waiver; per diem), which is 19.7× the national median of $331.94.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $6,541.04 per claim for T2016 (Habilitation, residential, waiver; per diem) — 19.7× the national median of $331.94.
Bills $3,418.68 per claim for S5140 (Foster care, adult; per diem) — 13.6× the national median of $252.32.
Bills $1,014.19 per claim for T2021 (Day habilitation, waiver; per 15 min) — 6.7× the national median of $150.51.
Billing above the 90th percentile for 3 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Day Training Developmentally Disabled Services Peers
Total spending distribution among 22 providers in this specialty
This provider's total spending of $144.1M is at the 50th percentile among 22 Day Training Developmentally Disabled Services providers.
Total Paid
$144.1M
$144,111,254
Total Claims
105K
Beneficiaries
45K
2.4 claims/patient
Avg Cost/Claim
$1K
#760 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
Creative Works is a Day Training Developmentally Disabled Services provider based in Westbrook, ME. From the 2018–2024 period, this provider received $144.1M in Medicaid payments across 105K claims.
Why This Matters
This provider received $144.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 18,013 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 8 distinct procedure codes. The top code (T2016 (Habilitation, residential, waiver; per diem)) accounts for 61% of total spending.
$88.3M
13K claims
$6,541.04
$331.94
Habilitation, residential, waiver; per diem
$88.3M
13K claims · 61.3%
Foster care, adult; per diem
$27.9M
8K claims · 19.3%
$20.4M
20K claims
$1,014.19
$150.51
Day habilitation, waiver; per 15 min
$20.4M
20K claims · 14.1%
$3.8M
15K claims
$251.03
$137.32
Habilitation, residential, waiver; 15 min
$3.8M
15K claims · 2.7%
$3.3M
39K claims
$82.44
$137.85
Other specified case management service, per 15 minutes
$3.3M
39K claims · 2.3%
Supported employment, per 15 min
$214K
3K claims · 0.1%
Case management, each 15 min
$181K
3K claims · 0.1%
$106K
3K claims · 0.1%
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