Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

New Horizon Counseling Center INC

Clinic/Center Mental Health (Including Community Mental Health Center)

South Ozone Park, New York

NPI: 1366430563

Risk Tier

High

Total Paid

$213.1M

$213,090,355

Total Claims

2.3M

Beneficiaries

665K

Avg Cost/Claim

$90.80

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (2)

Billing Swing

Experienced over 200% change in year-over-year billing with >$1M absolute change.

Billing changed from $12.6M (2019) to $46.7M (2020) — a 271% swing with $34.2M absolute change.

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 6 procedure codes: 90832 at 2.4× median, 99213 at 2.4× median.

Advanced Detection Signals

CUSUM Change Point

Billing shifted 3.4x in 2020-02 — a statistically significant structural change in billing behavior was detected.

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