National Mentor Healthcare LLC
Psychologist Intellectual & Developmental Disabilities
Millsboro, Delaware
NPI: 1588937486
Risk Tier
High
Total Paid
$108.7M
$108,675,194
Total Claims
309K
Beneficiaries
26K
Avg Cost/Claim
$351.67
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $523.58 per claim for T2025 (Waiver services, NOS; per 15 min), which is 4.2× the national median of $124.39.
Instant Volume
New provider billing over $1M in their first year of Medicaid participation.
Billed $22.6M in first year (2021).
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