Northeast Kingdom Human Services INC Ds Waiver
Clinic/Center Developmental Disabilities
Newport, Vermont
NPI: 1538292768
Risk Tier
High
Total Paid
$204.8M
$204,755,692
Total Claims
673K
Beneficiaries
74K
Avg Cost/Claim
$304.37
Active billing period: 83 months (2018-01 to 2024-11)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $7,409.48 per claim for 99199 (Unlisted special service, procedure, or report), which is 1374.7× the national median of $5.39.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 1 procedure codes: 99199 at 1374.7× 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