Is PDHCRC, INC. flagged for Medicaid fraud?

PDHCRC, INC. (NPI: 1164569802) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does PDHCRC, INC. bill Medicaid?

PDHCRC, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities provider. Located in JACKSON, MI.

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PDHCRC, INC.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities·JACKSON, MI·NPI: 1164569802Share

Compared to Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities Peers

Total spending distribution among 50 providers in this specialty

P25MedianP75P90

This provider's total spending of $27.9M is at the 25th percentile among 50 Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$27.9M

$27,871,186

Total Claims

142K

Beneficiaries

33K

4.4 claims/patient

Avg Cost/Claim

$196

Monthly Spending Trend

Yearly Spending

2018

$4.1M

+28%

2019

$5.2M

-27%

2020

$3.8M

+18%

2021

$4.5M

+10%

2022

$5.0M

-11%

2023

$4.4M

-80%

2024

$886K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 39% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2016Comprehensive community support services, per 15 minSee all providers →

$10.9M

4,722 claims

$2,303.50

$321.53

7.2×

Top 25%

H2016Top 25%

Comprehensive community support services, per 15 min

$10.9M

4,722 claims · 39.0%

Your Cost: $2,303.50/claim|Median: $321.53

7.2× median

H2015Comprehensive community support services, per 15 minSee all providers →

$7.0M

90K claims

$77.67

$96.24

0.8×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$7.0M

90K claims · 25.0%

Your Cost: $77.67/claim|Median: $96.24

0.8× median

T1020Personal care services, per diemSee all providers →

$5.0M

4,228 claims

$1,179.55

$296.27

4.0×

Top 25%

T1020Top 25%

Personal care services, per diem

$5.0M

4,228 claims · 17.9%

Your Cost: $1,179.55/claim|Median: $296.27

4.0× median

H0045Respite care services, not in the home, per diemSee all providers →

$1.7M

9,490 claims

$180.27

$119.19

1.5×

Normal range

H0045Normal range

Respite care services, not in the home, per diem

$1.7M

9,490 claims · 6.1%

Your Cost: $180.27/claim|Median: $119.19

1.5× median

H2023Supported employment, per 15 minSee all providers →

$1.3M

9,933 claims

$126.55

$103.94

1.2×

Normal range

H2023Normal range

Supported employment, per 15 min

$1.3M

9,933 claims · 4.5%

Your Cost: $126.55/claim|Median: $103.94

1.2× median

H0032Mental health service plan developmentSee all providers →

$700K

5,327 claims

$131.34

$80.64

1.6×

Top 25%

H0032Top 25%

Mental health service plan development

$700K

5,327 claims · 2.5%

Your Cost: $131.34/claim|Median: $80.64

1.6× median

S5151Unskilled respite care, per diemSee all providers →

$553K

4,194 claims

$131.77

$249.18

0.5×

Normal range

S5151Normal range

Unskilled respite care, per diem

$553K

4,194 claims · 2.0%

Your Cost: $131.77/claim|Median: $249.18

0.5× median

H2014Skills training & development, per 15 minSee all providers →

$480K

13K claims

$37.72

$83.88

0.4×

Normal range

H2014Normal range

Skills training & development, per 15 min

$480K

13K claims · 1.7%

Your Cost: $37.72/claim|Median: $83.88

0.4× median

T1017Targeted case management, per 15 minSee all providers →

$154K

646 claims

$238.28

$69.56

3.4×

Top 25%

T1017Top 25%

Targeted case management, per 15 min

$154K

646 claims · 0.6%

Your Cost: $238.28/claim|Median: $69.56

3.4× median

T1016Case management, each 15 minSee all providers →

$120K

605 claims

$197.79

$49.62

4.0×

Top 10%

T1016Top 10%

Case management, each 15 min

$120K

605 claims · 0.4%

Your Cost: $197.79/claim|Median: $49.62

4.0× median

H2025Ongoing support to maintain employment, per 15 minSee all providers →

$55K

313 claims

$175.48

$100.49

1.7×

Normal range

H2025Normal range

Ongoing support to maintain employment, per 15 min

$55K

313 claims · 0.2%

Your Cost: $175.48/claim|Median: $100.49

1.7× median

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