Is MEDSTAR, INC. flagged for Medicaid fraud?

MEDSTAR, INC. (NPI: 1124056296) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does MEDSTAR, INC. bill Medicaid?

MEDSTAR, INC. received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Ambulance provider. Located in CLINTON TOWNSHIP, MI.

What is NPI 1124056296?

NPI 1124056296 is the National Provider Identifier for MEDSTAR, INC.. They are a Ambulance provider based in CLINTON TOWNSHIP, MI. This NPI is registered with the CMS NPI Registry.

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MEDSTAR, INC.

Ambulance·CLINTON TOWNSHIP, MI·NPI: 1124056296Share

Compared to Ambulance Peers

Total spending distribution among 12 providers in this specialty

P25MedianP75P90

This provider's total spending of $50.5M is at the 25th percentile among 12 Ambulance providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$50.5M

$50,471,184

Total Claims

440K

Beneficiaries

378K

1.2 claims/patient

Avg Cost/Claim

$115

Monthly Spending Trend

Yearly Spending

2018

$3.5M

+19%

2019

$4.1M

+14%

2020

$4.7M

+46%

2021

$6.8M

+54%

2022

$10.5M

+4%

2023

$11.0M

-10%

2024

$9.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (A0427 (Ambulance, ALS emergency transport Level 1)) accounts for 33% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

A0427Ambulance, ALS emergency transport Level 1See all providers →

$16.8M

75K claims

$222.12

$164.22

1.4×

Normal range

A0427Normal range

Ambulance, ALS emergency transport Level 1

$16.8M

75K claims · 33.2%

Your Cost: $222.12/claim|Median: $164.22

1.4× median

A0428Ambulance service, BLS, non-emergency transportSee all providers →

$12.8M

91K claims

$140.39

$58.05

2.4×

Top 25%

A0428Top 25%

Ambulance service, BLS, non-emergency transport

$12.8M

91K claims · 25.3%

Your Cost: $140.39/claim|Median: $58.05

2.4× median

A0425Ground mileage, per statute mileSee all providers →

$11.9M

219K claims

$54.17

$23.36

2.3×

Top 25%

A0425Top 25%

Ground mileage, per statute mile

$11.9M

219K claims · 23.6%

Your Cost: $54.17/claim|Median: $23.36

2.3× median

A0429Ambulance, BLS emergency transportSee all providers →

$6.6M

43K claims

$154.69

$138.19

1.1×

Normal range

A0429Normal range

Ambulance, BLS emergency transport

$6.6M

43K claims · 13.0%

Your Cost: $154.69/claim|Median: $138.19

1.1× median

A0426Ambulance service, ALS, non-emergency transport, level 1See all providers →

$2.1M

9,218 claims

$226.82

$104.69

2.2×

Top 25%

A0426Top 25%

Ambulance service, ALS, non-emergency transport, level 1

$2.1M

9,218 claims · 4.1%

Your Cost: $226.82/claim|Median: $104.69

2.2× median

A0434Ambulance, specialty care transportSee all providers →

$165K

1,107 claims

$148.99

$252.36

0.6×

Normal range

A0434Normal range

Ambulance, specialty care transport

$165K

1,107 claims · 0.3%

Your Cost: $148.99/claim|Median: $252.36

0.6× median

M0245 See all providers →

$55K

178 claims

$306.77

$246.46

1.2×

Normal range

M0245Normal range

$55K

178 claims · 0.1%

Your Cost: $306.77/claim|Median: $246.46

1.2× median

M0244 See all providers →

$53K

97 claims

$542.41

$173.14

3.1×

Top 25%

M0244Top 25%

$53K

97 claims · 0.1%

Your Cost: $542.41/claim|Median: $173.14

3.1× median

A0998 See all providers →

$44K

228 claims

$194.29

$63.75

3.0×

Top 25%

A0998Top 25%

$44K

228 claims · 0.1%

Your Cost: $194.29/claim|Median: $63.75

3.0× median

A0433 See all providers →

$38K

123 claims

$306.60

$207.46

1.5×

Normal range

A0433Normal range

$38K

123 claims · 0.1%

Your Cost: $306.60/claim|Median: $207.46

1.5× median

M0243 See all providers →

$21K

74 claims

$288.91

$215.21

1.3×

Normal range

M0243Normal range

$21K

74 claims · 0.0%

Your Cost: $288.91/claim|Median: $215.21

1.3× median

M0247 See all providers →

$14K

54 claims

$253.70

$235.71

1.1×

Normal range

M0247Normal range

$14K

54 claims · 0.0%

Your Cost: $253.70/claim|Median: $235.71

1.1× median

A0422 See all providers →

241 claims

$0.00

$9.63

—

Normal range

A0422Normal range

241 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.63

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