Is CHILDRENS HEALTH CARE ASSOCIATES, INC flagged for Medicaid fraud?

CHILDRENS HEALTH CARE ASSOCIATES, INC (NPI: 1457446403) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does CHILDRENS HEALTH CARE ASSOCIATES, INC bill Medicaid?

CHILDRENS HEALTH CARE ASSOCIATES, INC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Emergency Medicine, Pediatric Emergency Medicine provider. Located in PHILADELPHIA, PA.

What is NPI 1457446403?

NPI 1457446403 is the National Provider Identifier for CHILDRENS HEALTH CARE ASSOCIATES, INC. They are a Emergency Medicine, Pediatric Emergency Medicine provider based in PHILADELPHIA, PA. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

CHILDRENS HEALTH CARE ASSOCIATES, INC

Emergency Medicine, Pediatric Emergency Medicine·PHILADELPHIA, PA·NPI: 1457446403Share

Active Billing Period:2018-01→2024-12(81 months)

Total Paid

$24.1M

$24,143,677

Total Claims

225K

Beneficiaries

222K

1.0 claims/patient

Avg Cost/Claim

$107

Monthly Spending Trend

Yearly Spending

2018

$126K

+36%

2019

$172K

+114%

2020

$370K

+724%

2021

$3.0M

+61%

2022

$4.9M

+39%

2023

$6.8M

+28%

2024

$8.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 10 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 52% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99284Emergency dept visit, high complexitySee all providers →

$12.5M

88K claims

$142.66

$69.51

2.1×

Top 25%

99284Top 25%

Emergency dept visit, high complexity

$12.5M

88K claims · 51.7%

Your Cost: $142.66/claim|Median: $69.51

2.1× median

99283Emergency dept visit, moderate complexitySee all providers →

$8.8M

98K claims

$89.94

$42.48

2.1×

Top 25%

99283Top 25%

Emergency dept visit, moderate complexity

$8.8M

98K claims · 36.6%

Your Cost: $89.94/claim|Median: $42.48

2.1× median

99285Emergency dept visit, high/urgent complexitySee all providers →

$2.7M

17K claims

$159.90

$85.65

1.9×

Top 25%

99285Top 25%

Emergency dept visit, high/urgent complexity

$2.7M

17K claims · 11.3%

Your Cost: $159.90/claim|Median: $85.65

1.9× median

99053 See all providers →

$29K

21K claims

$1.36

$0.38

3.6×

Normal range

99053Normal range

$29K

21K claims · 0.1%

Your Cost: $1.36/claim|Median: $0.38

3.6× median

99224 See all providers →

$18K

423 claims

$41.65

$17.79

2.3×

Top 25%

99224Top 25%

$18K

423 claims · 0.1%

Your Cost: $41.65/claim|Median: $17.79

2.3× median

99220 See all providers →

$15K

81 claims

$185.76

$73.56

2.5×

Top 5%

99220Top 5%

$15K

81 claims · 0.1%

Your Cost: $185.76/claim|Median: $73.56

2.5× median

99232Subsequent hospital care, per day, moderate complexitySee all providers →

$8K

87 claims

$87.97

$23.99

3.7×

Top 5%

99232Top 5%

Subsequent hospital care, per day, moderate complexity

$8K

87 claims · 0.0%

Your Cost: $87.97/claim|Median: $23.99

3.7× median

99217 See all providers →

$5K

63 claims

$72.80

$31.89

2.3×

Top 5%

99217Top 5%

$5K

63 claims · 0.0%

Your Cost: $72.80/claim|Median: $31.89

2.3× median

99238Hospital discharge day management, 30 minutes or lessSee all providers →

$2K

14 claims

$134.20

$37.22

3.6×

Top 1%

99238Top 1%

Hospital discharge day management, 30 minutes or less

$2K

14 claims · 0.0%

Your Cost: $134.20/claim|Median: $37.22

3.6× median

99282Emergency dept visit, low complexitySee all providers →

$2K

28 claims

$53.74

$37.72

1.4×

Normal range

99282Normal range

Emergency dept visit, low complexity

$2K

28 claims · 0.0%

Your Cost: $53.74/claim|Median: $37.72

1.4× median

Other Top Providers in Pennsylvania

View all →

Zoll Services LLC

Durable Medical Equipment & Medical Supplies

$504.0M

Commonwealth of Pennsylvania Department of Education

Local Education Agency (LEA)

$326.0M

Excel Copmanion Care INC

Home Health

$308.4M

Childrens Hospital of Philadelphia

General Acute Care Hospital Children

$286.9M

Procare Pharmacy Direct, Llc.

Pharmacy, Community/Retail Pharmacy

$227.3M

Similar Providers

Other top providers in Emergency Medicine, Pediatric Emergency Medicine

Southeastern Emergency Physicians LLC

Maysville, KY

$208.9M

← All providers All providers in Pennsylvania →How we detect fraud →