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

Granite Bay Care INC

Residential Treatment Facility Intellectual and/or Developmental Disabilities

Portland, Maine

NPI: 1518022763

Risk Tier

High

Total Paid

$281.7M

$281,653,043

Total Claims

226K

Beneficiaries

16K

Avg Cost/Claim

$1,245.57

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

Statistical Fraud Flags (2)

Cost Outlier

Billing over 3× the national median for specific procedure codes.

Bills $1,262.44 per claim for T2016 (Habilitation, residential, waiver; per diem), which is 3.8× the national median of $331.94.

Rate Outlier

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

Billing above the 90th percentile for 2 procedure codes: G9012 at 2.3× median, H0004 at 2.8× median.

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