When the Numbers Don't Add Up: Benford's Law Analysis
Benford's Law predicts that the leading digit of naturally occurring numbers follows a specific distribution — “1” appears about 30% of the time, while “9” appears only 4.6%. Real financial data follows this pattern. Fabricated data often doesn't. We tested 617,000 providers' claim amounts. These 200 deviate the most.
4.14
Highest chi-squared
200
Flagged providers
2.21
Avg chi-squared
$3.71B
Total spending
How Benford's Law Works
In naturally occurring datasets — financial transactions, population counts, street addresses — the leading digit “1” appears far more often than “9”. This is because numbers grow logarithmically: it takes a 100% increase to go from 1xx to 2xx, but only an 11% increase to go from 8xx to 9xx. When someone fabricates numbers, they tend to distribute digits more evenly, violating this law.
Expected Leading Digit Distribution
The chi-squared statistic measures how far a provider's actual digit distribution deviates from these expected values. Higher values indicate greater divergence from the natural pattern.
The Most Extreme Deviations
NPI: 1194926758 · 126 claims
4.14
chi-squared
$38.2M
total paid
126
total claims
NPI: 1942823042 · 100 claims
3.92
chi-squared
$4.5M
total paid
100
total claims
NPI: 1962068817 · 168 claims
3.67
chi-squared
$6.2M
total paid
168
total claims
NPI: 1801165170 · 125 claims
3.43
chi-squared
$6.8M
total paid
125
total claims
NPI: 1336382571 · 165 claims
3.41
chi-squared
$31.5M
total paid
165
total claims
The provider with the highest chi-squared score of 4.14 shows a leading-digit distribution that deviates significantly from what Benford's Law predicts. Across these 200 flagged providers, they collectively account for $3.71B in Medicaid payments and 28K claims.
What the Chi-Squared Statistic Means
The chi-squared test compares observed leading-digit frequencies against Benford's expected distribution. A value near 0 means the data perfectly matches the expected pattern. Values above 2.0 suggest significant deviation. Values above 3.0 are unusual enough to warrant investigation — the probability of this occurring by chance in natural data is very low.
Benford's Law has been used to detect fraud in tax returns, election results, and corporate accounting. In the context of Medicaid billing, a high chi-squared value could indicate round-number billing, repeated identical charges, or systematically inflated amounts — all patterns associated with fraudulent claims. However, legitimate explanations exist: providers with few distinct charge amounts or those who bill at fixed contract rates may naturally deviate from Benford's distribution.
Important Caveat
Deviation from Benford's Law alone is not proof of fraud. Some legitimate billing patterns — fixed-rate contracts, standardized fee schedules, or low claim counts — can produce high chi-squared values. This analysis identifies providers whose billing amounts have an unusual digit distribution, which can be a signal worth investigating alongside other indicators. It is most meaningful in combination with other anomaly flags.
Top 30 Highest Chi-Squared Providers
| # | Provider | Chi-Squared | Total Paid | Claims |
|---|---|---|---|---|
| 1 | NPI: 1194926758 NPI: 1194926758 | 4.1406 | $38.2M | 126 |
| 2 | NPI: 1942823042 NPI: 1942823042 | 3.9207 | $4.5M | 100 |
| 3 | NPI: 1962068817 NPI: 1962068817 | 3.6697 | $6.2M | 168 |
| 4 | NPI: 1801165170 NPI: 1801165170 | 3.4289 | $6.8M | 125 |
| 5 | Senior Resources of West Michigan NPI: 1336382571 | 3.4079 | $31.5M | 165 |
| 6 | NPI: 1811155369 NPI: 1811155369 | 3.3175 | $6.7M | 105 |
| 7 | NPI: 1295071074 NPI: 1295071074 | 3.3116 | $6.1M | 108 |
| 8 | NPI: 1366568347 NPI: 1366568347 | 3.2998 | $7.3M | 106 |
| 9 | NPI: 1306244959 NPI: 1306244959 | 3.2636 | $6.2M | 101 |
| 10 | NPI: 1356476261 NPI: 1356476261 | 3.2344 | $10.7M | 164 |
| 11 | NPI: 1215422746 NPI: 1215422746 | 3.2072 | $5.8M | 130 |
| 12 | NPI: 1396931622 NPI: 1396931622 | 3.1783 | $6.5M | 168 |
| 13 | NPI: 1124456355 NPI: 1124456355 | 3.0682 | $6.1M | 100 |
| 14 | NPI: 1134227465 NPI: 1134227465 | 2.9791 | $10.4M | 167 |
| 15 | Commonsense Housing INC NPI: 1083781991 | 2.9271 | $22.2M | 116 |
| 16 | Hope House Foundation NPI: 1073580163 | 2.8926 | $77.9M | 102 |
| 17 | NPI: 1386060424 NPI: 1386060424 | 2.8663 | $2.0M | 331 |
| 18 | NPI: 1609921949 NPI: 1609921949 | 2.8551 | $26.1M | 166 |
| 19 | NPI: 1427440650 NPI: 1427440650 | 2.7703 | $57.8M | 239 |
| 20 | NPI: 1861886996 NPI: 1861886996 | 2.7567 | $1.5M | 165 |
| 21 | NPI: 1417075862 NPI: 1417075862 | 2.7420 | $7.1M | 151 |
| 22 | NPI: 1396063624 NPI: 1396063624 | 2.7358 | $6.0M | 165 |
| 23 | NPI: 1205966942 NPI: 1205966942 | 2.7145 | $7.4M | 113 |
| 24 | NPI: 1831332691 NPI: 1831332691 | 2.7047 | $8.0M | 101 |
| 25 | NPI: 1245387349 NPI: 1245387349 | 2.6875 | $2.0M | 104 |
| 26 | NPI: 1326162140 NPI: 1326162140 | 2.6771 | $4.5M | 116 |
| 27 | NPI: 1205954328 NPI: 1205954328 | 2.6238 | $3.6M | 117 |
| 28 | Arirang Adult Medical Day Care NPI: 1518159920 | 2.5938 | $29.0M | 110 |
| 29 | Lighthouse, Inc. NPI: 1982779203 | 2.5938 | $38.9M | 183 |
| 30 | NPI: 1730337304 NPI: 1730337304 | 2.5830 | $38.5M | 104 |
Key Takeaways
- ▸200 providers show statistically significant deviations from Benford's Law in their billing amounts.
- ▸The highest chi-squared value is 4.14, far exceeding the threshold for statistical significance.
- ▸These 200 providers account for $3.71B in total Medicaid spending.
- ▸Benford's Law analysis is a screening tool, not a verdict. High chi-squared values warrant investigation but do not prove fraud on their own.
Source: HHS T-MSIS Other Services File (2018–2024) · 227M records