State of Missouri
Rehabilitation Counselor
Jefferson City, Missouri
NPI: 1437781499
Risk Tier
Critical
Total Paid
$160.2M
$160,213,996
Total Claims
257K
Beneficiaries
58K
Avg Cost/Claim
$622.27
Active billing period: 83 months (2018-01 to 2024-11)
Statistical Fraud Flags (3)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $2,978.25 per claim for H0018 (Behavioral health; short-term residential, per diem), which is 6.4× the national median of $467.51.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Spending Spike
Experienced a dramatic increase in billing over a short period.
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