Community Care Health Plan, INC
PACE Provider Organization
Brookfield, Wisconsin
NPI: 1154479822
Risk Tier
High
Total Paid
$63.1M
$63,056,936
Total Claims
902K
Beneficiaries
217K
Avg Cost/Claim
$69.94
Statistical Fraud Flags (2)
New Entrant
Started billing recently but already receiving millions in Medicaid payments.
First appeared in 2024-01 and has already billed $63.1M, averaging $5.3M/month across 12 months.
Instant Volume
New provider billing over $1M in their first year of Medicaid participation.
Billed $63.1M in first year (2024).
Advanced Detection Signals
Billing Velocity
3415.2 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