Community Concepts Inc.
Community/Behavioral Health
Dumfries, Virginia
NPI: 1356772339
Risk Tier
Elevated
Total Paid
$63.6M
$63,602,214
Total Claims
32K
Beneficiaries
10K
Avg Cost/Claim
$1,986.45
Statistical Fraud Flags (1)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $2,248.16 per claim for H2022 (Community-based wrap-around services, per diem), which is 6.7× the national median of $336.31.
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