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

Marks Homecare Agency INC

In Home Supportive Care·Corona, NY·NPI: 1376097303SharePrint Report

Red Flags Explained

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

Billing Velocity3621.6 claims/working day
Change PointBilling shifted 4.7x in 2022-02

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $249.20 per claim for 99199 (Unlisted special service, procedure, or report) — 46.2× the national median of $5.39.

This is a statistical summary, not an accusation. See our methodology.

Compared to In Home Supportive Care Peers

Total spending distribution among 57 providers in this specialty

P25MedianP75P90

This provider's total spending of $1.08B is at the 99th percentile among 57 In Home Supportive Care providers.

Above 99th percentile for this specialty — higher spending than 56 of 57 peers

Active Billing Period:2018-012024-12(84 months)

Total Paid

$1.08B

$1,081,483,693

Total Claims

6.7M

Beneficiaries

304K

22.0 claims/patient

Avg Cost/Claim

$162

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

🔍 Analysis

Provider Overview

Marks Homecare Agency INC is a In Home Supportive Care provider based in Corona, NY. From the 2018–2024 period, this provider received $1.1B in Medicaid payments across 6.7M claims.

Why This Matters

This provider received $1.1B in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 135,185 Medicaid beneficiaries for a full year at average per-enrollee costs.

4155% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$8.2M
+327%
2019
$35.1M
+92%
2020
$67.4M
+87%
2021
$126.1M
+42%
2022
$179.5M
+76%
2023
$316.0M
+11%
2024
$349.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 4 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 99% of total spending.

T1019Top 25%

Personal care services, per 15 min

$1.07B

6.6M claims · 98.7%

Your Cost: $160.54/claim|Median: $82.47
1.9× median
T1020Normal range

Personal care services, per diem

$11.8M

33K claims · 1.1%

Your Cost: $356.90/claim|Median: $296.27
1.2× median
T1022Normal range

$2.1M

11K claims · 0.2%

Your Cost: $195.97/claim|Median: $184.03
1.1× median
99199Top 5%

Unlisted special service, procedure, or report

$464K

2K claims · 0.0%

Your Cost: $249.20/claim|Median: $5.39
46.2× median