Single-test outliers in New Hampshire Medicaid data. These are individual statistical flags β most are informational.
Important context: These findings identify statistically unusual billing patterns, not determinations of wrongdoing. Cost-per-claim comparisons may flag hospital outpatient departments whose reimbursements include facility fees, bundled services, or all-inclusive rates. High claims-per-beneficiary ratios may reflect legitimate care patterns at behavioral health facilities, pediatric specialty centers, or residential care programs. Additional investigation and clinical context are required before drawing any conclusions.
For provider level analytics using multiple independent tests, see the Watchlist β which flags providers only when 2+ different detection methods agree. These single-test outliers below are primarily informational; only Cost Outliers and Overutilization are flagged as critical/warning.
critical
38
warning
91
info
1,001
Total
1,130
SPEARE MEMORIAL HOSPITAL (1326587635) bills $366.78/claim for 90832 (Psytx w pt 30 minutes) vs avg $21.49 (+9.0Ο). $15,405 across 42 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
MENTOR ABI, LLC (1386879096): 35.8 claims/beneficiary (avg 3.4). 17,256 claims, 482 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
VNA PERSONAL SERVICES INC (1316099690): 32.7 claims/beneficiary (avg 3.4). 41,153 claims, 1,260 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
THE NEW LONDON HOSPITAL ASSOCIATION, INC. (1770684672) bills $74.38/claim for 87880 (Strep a assay w/optic) vs avg $9.00 (+6.8Ο). $14,875 across 200 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
IMPRESS HEALTHCARE CORPORATION (1336778208): 31.2 claims/beneficiary (avg 3.4). 38,374 claims, 1,229 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
NH EYE ASSOCIATES PLLC (1518044213) bills $97.18/claim for 92340 (Fit spectacles monofocal) vs avg $27.23 (+6.5Ο). $20,700 across 213 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
MAY ALDAABIL (1306243910) bills $145.25/claim for 99211 (Off/op est may x req phy/qhp) vs avg $15.96 (+6.3Ο). $100,225 across 690 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
DREAM VISION LLC (1366136525): 28.4 claims/beneficiary (avg 3.4). 3,148 claims, 111 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
KIMI NICHOLS CENTER (1922719111): 27.9 claims/beneficiary (avg 3.4). 35,179 claims, 1,259 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
ASCENTRIA COMMUNITY SERVICES, INC (1760601017): 27.8 claims/beneficiary (avg 3.4). 63,158 claims, 2,271 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
LIFESHARE MANAGEMENT GROUP, INC. (1720136971) bills $2,284.88/claim for T2021 (Day habil waiver per 15 min) vs avg $289.42 (+5.8Ο). $1,464,610 across 641 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SPEARE MEMORIAL HOSPITAL (1326587635) bills $259.39/claim for 99214 (Office o/p est mod 30 min) vs avg $51.69 (+5.8Ο). $2,185,122 across 8,424 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
NFI NORTH, INC (1871669234): 26.7 claims/beneficiary (avg 3.4). 9,940 claims, 372 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
PHOENIX HOUSES OF NE (1356441141): 26.5 claims/beneficiary (avg 3.4). 73,274 claims, 2,769 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
AAA HOME HEALTH LLC (1366054249): 26.2 claims/beneficiary (avg 3.4). 1,700 claims, 65 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
SPEARE MEMORIAL HOSPITAL (1437291515) bills $244.25/claim for 99214 (Office o/p est mod 30 min) vs avg $51.69 (+5.3Ο). $41,034 across 168 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
RESIDENTIAL RESOURCES, INC (1033783097): 25.4 claims/beneficiary (avg 3.4). 29,715 claims, 1,172 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
FOAD RASEKH (1295018877) bills $74.40/claim for D1351 (Sealant per tooth) vs avg $28.37 (+5.0Ο). $149,096 across 2,004 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
COUNTY OF CHESHIRE (1417614827) bills $313.16/claim for A0427 (Als1-emergency) vs avg $108.76 (+4.9Ο). $78,604 across 251 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
THE NEW LONDON HOSPITAL ASSOCIATION, INC. (1770684672) bills $39.26/claim for 96110 (Developmental screen w/score) vs avg $6.84 (+4.8Ο). $45,733 across 1,165 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
MONADNOCK COMMUNITY HOSPITAL (1457304149) bills $135.94/claim for 71046 (X-ray exam chest 2 views) vs avg $23.91 (+4.5Ο). $108,750 across 800 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
MOULTONBOROUGH SCHOOL DISTRICT (1891106522) bills $80.90/claim for H2017 (Psysoc rehab svc, per 15 min) vs avg $22.88 (+4.4Ο). $14,804 across 183 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SPEARE MEMORIAL HOSPITAL (1437291515) bills $143.56/claim for 99213 (Office o/p est low 20 min) vs avg $35.27 (+4.4Ο). $1,013,824 across 7,062 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
NEXT STEPS COMMUNITY SERVICES LLC (1003403221) bills $9,957.70/claim for T1020 (Personal care ser per diem) vs avg $1,358.73 (+4.3Ο). $15,016,219 across 1,508 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
LABORATORY CORPORATION OF AMERICA HOLDINGS (1093793317) bills $13.56/claim for 80050 (General health panel) vs avg $7.92 (+4.3Ο). $12,935 across 954 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
CONCORD HOSPITAL-FRANKLIN (1114005535) bills $140.99/claim for 94640 (Airway inhalation treatment) vs avg $27.39 (+4.3Ο). $14,381 across 102 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
ANDROSCOGGIN VALLEY HOSPITAL, INC. (1386680593) bills $705.87/claim for 93306 (Tte w/doppler complete) vs avg $134.43 (+4.3Ο). $19,058 across 27 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
PREFERRED HOME HEALTH CARE AND NURSING SERVICES (1568702744) bills $71.14/claim for E0570 (Nebulizer, with compressor) vs avg $12.40 (+4.3Ο). $165,890 across 2,332 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
1972577104 (1972577104) bills $44.45/claim for 90461 (Im admin each addl component) vs avg $6.02 (+4.1Ο). $10,491 across 236 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
ASCENTRIA COMMUNITY SERVICES, INC (1174769384) bills $76.70/claim for H2017 (Psysoc rehab svc, per 15 min) vs avg $22.88 (+4.1Ο). $169,351 across 2,208 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
LITTLETON HOSPITAL ASSOCIATION (1811944523) bills $92.74/claim for 99212 (Office o/p est sf 10 min) vs avg $21.74 (+4.1Ο). $16,044 across 173 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SIDDHARTH SERVICES, INC. (1346965480): 24.1 claims/beneficiary (avg 3.4). 84,663 claims, 3,509 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
LIFE TRANSITION SERVICES, LLC (1366021289): 24.1 claims/beneficiary (avg 3.4). 20,636 claims, 856 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
FARMSTEADS OF NEW ENGLAND (1336726496): 23.9 claims/beneficiary (avg 3.4). 19,408 claims, 813 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
MONADNOCK WORKSOURCE INCORPORATED (1114518974): 23.9 claims/beneficiary (avg 3.4). 14,647 claims, 614 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
SUMMIT NEW HAMPSHIRE LLC (1578262317): 23.8 claims/beneficiary (avg 3.4). 36,403 claims, 1,528 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
COMMUNITY INTEGRATED SERVICES, INC (1578934345): 23.4 claims/beneficiary (avg 3.4). 48,995 claims, 2,098 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
NASHUA CENTER FOR THE MULTIPLY HANDICAPPED, INC. (1124144084): 23.3 claims/beneficiary (avg 3.4). 27,368 claims, 1,175 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
STATE OF NEW HAMPSHIRE (1134731185): 21.8 claims/beneficiary (avg 3.4). 5,025 claims, 231 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
METRO TREATMENT OF NEW HAMPSHIRE, LP (1902012123): 21.6 claims/beneficiary (avg 3.4). 1,404,376 claims, 64,973 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
J & K STAFFING SOLUTIONS, LLC (1972640407): 21.3 claims/beneficiary (avg 3.4). 80,910 claims, 3,791 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
METRO TREATMENT OF NEW HAMPSHIRE, LP (1093849994): 21.2 claims/beneficiary (avg 3.4). 958,201 claims, 45,197 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
METRO TREATMENT OF NEW HAMPSHIRE, LP (1861617318): 20.8 claims/beneficiary (avg 3.4). 590,879 claims, 28,401 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
COMMUNITY PARTNERS FOR CHANGE, INC (1396329959): 20.4 claims/beneficiary (avg 3.4). 12,879 claims, 632 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
NORTHEAST FAMILY SERVICES OF NEW HAMPSHIRE, INC. (1609348465): 19.6 claims/beneficiary (avg 3.4). 119,776 claims, 6,108 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
PEMI BAKER REGIONAL SCHOOL DISTRICT (1588878169): 19.6 claims/beneficiary (avg 3.4). 19,770 claims, 1,011 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
MAY ALDAABIL (1306243910) bills $60.17/claim for G0463 (Hospital outpt clinic visit) vs avg $12.98 (+3.8Ο). $10,650 across 177 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
GATEWAYS COMMUNITY SERVICES (1508920364): 19.3 claims/beneficiary (avg 3.4). 3,635 claims, 188 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
HILARY HAMER (1841720109) bills $113.76/claim for 92014 (Compre oph exam est pt 1/>) vs avg $52.57 (+3.8Ο). $92,602 across 814 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
HCA HEALTH SERVICES OF NEW HAMPSHIRE, INC. (1881476745) bills $199.35/claim for A0425 (Ground mileage) vs avg $26.66 (+3.8Ο). $15,948 across 80 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.