Ambercare Home Health Care Corporation
Home Health
Albuquerque, New Mexico
NPI: 1336117621
Risk Tier
High
Total Paid
$518.1M
$518,099,159
Total Claims
3.9M
Beneficiaries
440K
Avg Cost/Claim
$134.40
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $353.97 per claim for 99509 (Home visit, assistance w/ ADLs), which is 6.8× the national median of $51.71.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: 99509 at 6.8× median, S5110 at 2.9× median.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 5.1x in 2020-08 — a statistically significant structural change in billing behavior was detected.
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