Regents of the University of Michigan
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 54 procedure codes: 99285 at 6.3× median, 99284 at 3.0× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $536.03 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 6.3× the national median of $85.65.
Bills $211.88 per claim for 99284 (Emergency dept visit, high complexity) — 3.0× the national median of $69.51.
Bills $2,587.05 per claim for 42820 (Tonsillectomy and adenoidectomy, under age 12) — 7.8× the national median of $331.68.
Billing above the 90th percentile for 4 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$317.8M
$317,769,537
Total Claims
8.7M
Beneficiaries
7.4M
1.2 claims/patient
Avg Cost/Claim
$37
#225 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Regents of the University of Michigan is a Clinic/Center, End-Stage Renal Disease (ESRD) Treatment provider based in Ann Arbor, MI. From the 2018–2024 period, this provider received $317.8M in Medicaid payments across 8.7M claims.
Why This Matters
This provider received $317.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 39,721 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (G0463 (Hospital outpatient clinic visit)) accounts for 18% of total spending.
$56.9M
1.2M claims
$45.72
$26.41
Hospital outpatient clinic visit
$56.9M
1.2M claims · 17.9%
$28.8M
54K claims
$536.03
$85.65
Emergency dept visit, high/urgent complexity
$28.8M
54K claims · 9.1%
$11.3M
53K claims
$211.88
$69.51
Emergency dept visit, high complexity
$11.3M
53K claims · 3.5%
$7.6M
2K claims
$4,484.45
$5,391.55
Injection, pembrolizumab, 1 mg
$7.6M
2K claims · 2.4%
$7.0M
5K claims · 2.2%
$6.1M
2K claims
$2,587.05
$331.68
Tonsillectomy and adenoidectomy, under age 12
$6.1M
2K claims · 1.9%
$5.9M
6K claims · 1.9%
$5.5M
44K claims
$123.80
$42.48
Emergency dept visit, moderate complexity
$5.5M
44K claims · 1.7%
$5.4M
14K claims
$392.58
$133.68
MRI brain without contrast, then with contrast
$5.4M
14K claims · 1.7%
$5.2M
34K claims
$150.72
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$5.2M
34K claims · 1.6%
$4.8M
3K claims
$1,407.15
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$4.8M
3K claims · 1.5%
$4.0M
2K claims · 1.2%
$3.7M
17K claims
$216.40
$54.68
Echocardiography, transthoracic, complete, with Doppler
$3.7M
17K claims · 1.2%
$3.4M
13K claims
$262.93
$260.56
Intensity modulated radiation treatment delivery, complex
$3.4M
13K claims · 1.1%
$2.9M
38K claims
$75.15
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$2.9M
38K claims · 0.9%
$2.8M
216 claims
$13,048.33
$17,264.74
Ocrelizumab (Ocrevus) injection, 1 mg
$2.8M
216 claims · 0.9%
$2.7M
9K claims
$285.23
$470.36
Injection, onabotulinumtoxinA, 1 unit
$2.7M
9K claims · 0.8%
$2.6M
2K claims
$1,636.84
$763.43
Unlisted procedure, dentoalveolar structures
$2.6M
2K claims · 0.8%
$2.5M
76K claims
$33.38
$33.11
Therapeutic activities, each 15 min
$2.5M
76K claims · 0.8%
Colonoscopy with biopsy
$2.5M
5K claims · 0.8%
$2.5M
104K claims
$24.26
$24.49
Therapeutic exercises, each 15 min
$2.5M
104K claims · 0.8%
$2.5M
5K claims
$469.28
$233.73
Polysomnography, sleep study, 6+ hours
$2.5M
5K claims · 0.8%
$2.5M
983 claims · 0.8%
$2.4M
34K claims
$72.13
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$2.4M
34K claims · 0.8%
Upper GI endoscopy with biopsy
$2.4M
8K claims · 0.8%
Psychotherapy, 60 minutes
$2.1M
29K claims · 0.7%
$2.0M
53K claims
$37.38
$38.92
IV infusion, hydration, each additional hour
$2.0M
53K claims · 0.6%
$1.9M
34K claims
$56.34
$69.35
Preventive medicine, established patient, infant (under 1)
$1.9M
34K claims · 0.6%
$1.8M
32K claims
$56.97
$75.18
Preventive medicine, established patient, age 1-4
$1.8M
32K claims · 0.6%
PET imaging for limited area
$1.8M
2K claims · 0.6%
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