Adventist Health System-sunbelt, INC
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $10.8M (2018) to $33.8M (2019) — a 215% swing with $23.1M absolute change.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $176.51 per claim for 90935 (Hemodialysis, one evaluation) — 7.4× the national median of $23.72.
Bills $285.61 per claim for 96367 — 9.8× the national median of $29.27.
Bills $19.27 per claim for 84703 (Human chorionic gonadotropin (hCG) quantitative blood test) — 4.6× the national median of $4.20.
Billing in the top 1% nationally for 1 procedure code: 96367.
This is a statistical summary, not an accusation. See our methodology.
Compared to Ambulance, Land Transport Peers
Total spending distribution among 11 providers in this specialty
This provider's total spending of $174.0M is at the 90th percentile among 11 Ambulance, Land Transport providers.
Above 90th percentile for this specialty — higher spending than 9 of 11 peers
Total Paid
$174.0M
$173,979,588
Total Claims
7.6M
Beneficiaries
4.9M
1.6 claims/patient
Avg Cost/Claim
$23
#559 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Adventist Health System-sunbelt, INC is a Ambulance, Land Transport provider based in Orlando, FL. From the 2018–2024 period, this provider received $174.0M in Medicaid payments across 7.6M claims.
Why This Matters
This provider received $174.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,747 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 12% of total spending.
$20.8M
321K claims
$64.73
$42.48
Emergency dept visit, moderate complexity
$20.8M
321K claims · 11.9%
$15.8M
257K claims
$61.45
$69.51
Emergency dept visit, high complexity
$15.8M
257K claims · 9.1%
$8.6M
134K claims
$64.32
$85.65
Emergency dept visit, high/urgent complexity
$8.6M
134K claims · 4.9%
Speech/hearing/language treatment
$8.3M
69K claims · 4.8%
Therapeutic exercises, each 15 min
$5.0M
98K claims · 2.9%
$5.0M
40K claims
$125.05
$65.76
CT abdomen and pelvis with contrast
$5.0M
40K claims · 2.9%
Hemodialysis, one evaluation
$4.8M
27K claims · 2.8%
Comprehensive metabolic panel
$4.3M
294K claims · 2.5%
$3.8M
13K claims · 2.2%
$3.5M
59K claims
$59.02
$37.72
Emergency dept visit, low complexity
$3.5M
59K claims · 2.0%
$3.0M
53K claims
$55.97
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$3.0M
53K claims · 1.7%
$2.9M
63K claims
$46.54
$38.92
IV infusion, hydration, each additional hour
$2.9M
63K claims · 1.7%
$2.9M
151K claims
$19.27
$4.20
Human chorionic gonadotropin (hCG) quantitative blood test
$2.9M
151K claims · 1.7%
$2.8M
118K claims
$23.93
$99.39
Hospital observation service, per hour
$2.8M
118K claims · 1.6%
$2.6M
64K claims
$40.88
$33.11
Therapeutic activities, each 15 min
$2.6M
64K claims · 1.5%
$2.3M
58K claims
$39.70
$63.08
Infectious disease detection (COVID-19)
$2.3M
58K claims · 1.3%
$2.2M
54K claims
$39.87
$3.42
Low osmolar contrast material, 300-399 mg iodine/ml, per ml
$2.2M
54K claims · 1.2%
CT head/brain without contrast
$2.1M
40K claims · 1.2%
$1.9M
136K claims
$13.82
$14.92
Therapeutic/prophylactic/diagnostic IV push, each additional substance
$1.9M
136K claims · 1.1%
$1.8M
1K claims
$1,403.00
$5,391.55
Injection, pembrolizumab, 1 mg
$1.8M
1K claims · 1.1%
$1.6M
18K claims
$88.54
$60.19
CT abdomen and pelvis without contrast
$1.6M
18K claims · 0.9%
$1.5M
21K claims
$71.86
$52.03
Emergency dept visit, minimal complexity
$1.5M
21K claims · 0.9%
$1.4M
152K claims
$8.99
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$1.4M
152K claims · 0.8%
$1.3M
30K claims
$45.12
$0.22
Injection, lidocaine HCl for IV infusion
$1.3M
30K claims · 0.8%
$1.3M
7K claims
$187.24
$260.56
Intensity modulated radiation treatment delivery, complex
$1.3M
7K claims · 0.7%
$1.2M
12K claims
$103.63
$92.96
CT angiography, chest, with contrast
$1.2M
12K claims · 0.7%
$1.2M
15K claims
$77.81
$47.89
Physical therapy evaluation, low complexity
$1.2M
15K claims · 0.7%
$1.2M
24K claims
$48.04
$61.57
IV infusion, hydration, initial, 31 minutes to 1 hour
$1.2M
24K claims · 0.7%
Basic metabolic panel
$1.1M
141K claims · 0.7%
$1.1M
15K claims
$72.14
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$1.1M
15K claims · 0.6%
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