Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Creative Networks, L.l.c.

Case Management·Phoenix, AZ·NPI: 1215021019Share

Compared to Case Management Peers

Total spending distribution among 137 providers in this specialty

P25MedianP75P90

This provider's total spending of $159.7M is at the 50th percentile among 137 Case Management providers.

Active Billing Period:2018-012024-12(84 months)
Sharp billing drop in final month

Total Paid

$159.7M

$159,682,965

Total Claims

1.7M

Beneficiaries

89K

18.9 claims/patient

Avg Cost/Claim

$95

#654 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Creative Networks, L.l.c. is a Case Management provider based in Phoenix, AZ. From the 2018–2024 period, this provider received $159.7M in Medicaid payments across 1.7M claims.

Important Context

  • ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.

Why This Matters

This provider received $159.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,960 Medicaid beneficiaries for a full year at average per-enrollee costs.

22% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$20.6M
+1%
2019
$20.9M
+10%
2020
$22.9M
-3%
2021
$22.2M
-1%
2022
$22.0M
+18%
2023
$26.0M
-4%
2024
$25.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 5 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 81% of total spending.

S5125Normal range

Attendant care services, per 15 min

$130.1M

1.3M claims · 81.5%

Your Cost: $102.24/claim|Median: $82.34
1.2× median
T2017Normal range

Habilitation, residential, waiver; 15 min

$14.7M

209K claims · 9.2%

Your Cost: $70.37/claim|Median: $137.32
0.5× median
S5150Normal range

Unskilled respite care, per 15 min

$13.6M

190K claims · 8.5%

Your Cost: $71.67/claim|Median: $84.46
0.8× median
S5151Normal range

Unskilled respite care, per diem

$688K

2K claims · 0.4%

Your Cost: $301.58/claim|Median: $249.18
1.2× median
S5130Normal range

Homemaker service, NOS; per 15 min

$600K

10K claims · 0.4%

Your Cost: $62.57/claim|Median: $48.76
1.3× median