Alaska Native Tribal Health Consortium
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $539.40 per claim for 87635 (COVID-19 SARS-CoV-2 amplified probe detection), which is 13.6× the national median of $39.70.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 281 procedure codes: 99211 at 22.2× median, 87635 at 13.6× median.
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $286.80 per claim for 99211 (Office/outpatient visit, minimal complexity) — 22.2× the national median of $12.93.
Bills $539.40 per claim for 87635 (COVID-19 SARS-CoV-2 amplified probe detection) — 13.6× the national median of $39.70.
Bills $296.24 per claim for 80053 (Comprehensive metabolic panel) — 40.9× the national median of $7.24.
Billing in the top 1% nationally for 27 procedure codes: 99211, 87635, 80053.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $397.2M is at the 75th percentile among 156 General Acute Care Hospital providers.
Total Paid
$397.2M
$397,151,977
Total Claims
2.2M
Beneficiaries
1.9M
1.1 claims/patient
Avg Cost/Claim
$185
#161 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Alaska Native Tribal Health Consortium is a General Acute Care Hospital provider based in Anchorage, AK. From the 2018–2024 period, this provider received $397.2M in Medicaid payments across 2.2M claims.
Why This Matters
This provider received $397.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 49,643 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 (99211 (Office/outpatient visit, minimal complexity)) accounts for 19% of total spending.
$73.5M
256K claims
$286.80
$12.93
Office/outpatient visit, minimal complexity
$73.5M
256K claims · 18.5%
$64.6M
120K claims
$539.40
$39.70
COVID-19 SARS-CoV-2 amplified probe detection
$64.6M
120K claims · 16.3%
Comprehensive metabolic panel
$20.1M
68K claims · 5.1%
Hospital outpatient clinic visit
$19.0M
55K claims · 4.8%
$18.0M
86K claims
$208.26
$42.48
Emergency dept visit, moderate complexity
$18.0M
86K claims · 4.5%
$9.6M
21K claims
$463.21
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$9.6M
21K claims · 2.4%
Emergency dept visit, low complexity
$8.0M
18K claims · 2.0%
$7.8M
14K claims · 2.0%
$7.4M
36K claims
$206.35
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$7.4M
36K claims · 1.9%
$7.4M
55K claims
$135.01
$24.95
Chlamydia detection, nucleic acid, amplified probe
$7.4M
55K claims · 1.9%
$7.0M
27K claims
$256.79
$5.31
Urine culture, colony count, with identification
$7.0M
27K claims · 1.8%
Vitamin D, 25 hydroxy
$6.5M
23K claims · 1.6%
$6.2M
18K claims
$352.09
$91.47
Proprietary lab analysis, genomic sequencing
$6.2M
18K claims · 1.6%
$6.0M
11K claims · 1.5%
$5.7M
13K claims
$445.87
$9.56
Therapeutic injection, subcutaneous/intramuscular
$5.7M
13K claims · 1.4%
$5.5M
11K claims
$519.71
$3.42
Low osmolar contrast material, 300-399 mg iodine/ml, per ml
$5.5M
11K claims · 1.4%
Basic metabolic panel
$4.6M
11K claims · 1.2%
$4.4M
54K claims
$81.06
$69.51
Emergency dept visit, high complexity
$4.4M
54K claims · 1.1%
Thyroid stimulating hormone (TSH)
$4.0M
38K claims · 1.0%
$3.9M
8K claims · 1.0%
$3.1M
35K claims
$88.71
$1.57
Collection of venous blood by venipuncture
$3.1M
35K claims · 0.8%
$3.1M
8K claims · 0.8%
$3.0M
6K claims
$502.19
$25.57
HPV detection, high-risk types, nucleic acid
$3.0M
6K claims · 0.8%
Chest X-ray, 2 views
$2.8M
20K claims · 0.7%
$2.6M
5K claims · 0.7%
$2.4M
5K claims
$516.11
$65.45
Respiratory virus detection, 3-5 targets, multiplex
$2.4M
5K claims · 0.6%
$2.4M
4K claims
$541.41
$28.46
Streptococcus Group A detection, nucleic acid, amplified probe
$2.4M
4K claims · 0.6%
$2.4M
10K claims
$236.00
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$2.4M
10K claims · 0.6%
$2.4M
7K claims · 0.6%
$2.3M
7K claims
$331.81
$65.64
Influenza virus detection, reverse transcription, amplified probe
$2.3M
7K claims · 0.6%
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