Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 780% from 2022 to 2023.
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:
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Total Paid
$0
$0
Total Claims
0
Beneficiaries
0
Avg Cost/Claim
$0
🔍 Analysis
Provider Overview
Karen Thornton is a Family Medicine provider based in New York, NY. From the 2018–2024 period, this provider received $0 in Medicaid payments across 0 claims.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 10 distinct procedure codes. The top code (U0003 (Infectious disease detection (COVID-19))) accounts for 0% of total spending.
$8.1M
140K claims
$57.72
$63.08
Infectious disease detection (COVID-19)
$8.1M
140K claims · 0.0%
$2.7M
137K claims
$19.46
$15.76
Infectious disease detection, COVID-19, antigen
$2.7M
137K claims · 0.0%
$1.1M
41K claims
$27.67
$30.53
SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read
$1.1M
41K claims · 0.0%
$714K
25K claims
$28.72
$39.70
COVID-19 SARS-CoV-2 amplified probe detection
$714K
25K claims · 0.0%
$517K
120K claims
$4.31
$12.93
Office/outpatient visit, minimal complexity
$517K
120K claims · 0.0%
$97K
12K claims
$8.00
$12.59
Influenza virus detection, rapid test
$97K
12K claims · 0.0%
$81K
2,167 claims
$37.31
$57.85
Office/outpatient visit, new patient, low-mod complexity
$81K
2,167 claims · 0.0%
$53K
2,366 claims
$22.61
$17.15
Specimen collection for COVID-19 testing
$53K
2,366 claims · 0.0%
Global fee, urgent care centers
$52K
511 claims · 0.0%
$52K
2,121 claims
$24.29
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$52K
2,121 claims · 0.0%
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