Alabama Department of Mental Health and Mental Retardation
Community/Behavioral Health
Montgomery, Alabama
NPI: 1083765689
Risk Tier
Critical
Total Paid
$559.5M
$559,483,344
Total Claims
11.2M
Beneficiaries
4.0M
Avg Cost/Claim
$49.76
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (3)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: 96101 at 3.4× median, 96102 at 6.1× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Claims Per Patient
Filing an unusually high number of claims per beneficiary compared to peers.
Advanced Detection Signals
Billing Velocity
6083.8 claims per working day — may exceed physically possible volume for a single provider.
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