Is PREMIER KIDS CARE, INC. flagged for Medicaid fraud?

PREMIER KIDS CARE, INC. (NPI: 1548237563) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does PREMIER KIDS CARE, INC. bill Medicaid?

PREMIER KIDS CARE, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Pharmacy, Community/Retail Pharmacy provider. Located in MONROE, GA.

What is NPI 1548237563?

NPI 1548237563 is the National Provider Identifier for PREMIER KIDS CARE, INC.. They are a Pharmacy, Community/Retail Pharmacy provider based in MONROE, GA. This NPI is registered with the CMS NPI Registry.

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PREMIER KIDS CARE, INC.

Pharmacy, Community/Retail Pharmacy·MONROE, GA·NPI: 1548237563Share

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$19.6M

$19,632,346

Total Claims

55K

Beneficiaries

52K

1.1 claims/patient

Avg Cost/Claim

$357

Monthly Spending Trend

Yearly Spending

2018

$2.8M

+39%

2019

$3.9M

+41%

2020

$5.5M

-22%

2021

$4.3M

-43%

2022

$2.5M

-75%

2023

$611K

-74%

2024

$160K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (A9274 (External ambulatory insulin delivery system, disposable)) accounts for 41% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

A9274External ambulatory insulin delivery system, disposableSee all providers →

$8.1M

18K claims

$446.09

$466.16

1.0×

Normal range

A9274Normal range

External ambulatory insulin delivery system, disposable

$8.1M

18K claims · 41.3%

Your Cost: $446.09/claim|Median: $466.16

1.0× median

A9276Breath test analyzer, FDA approved, disposableSee all providers →

$6.4M

20K claims

$321.44

$294.58

1.1×

Normal range

A9276Normal range

Breath test analyzer, FDA approved, disposable

$6.4M

20K claims · 32.4%

Your Cost: $321.44/claim|Median: $294.58

1.1× median

E0784External ambulatory infusion pump, insulinSee all providers →

$2.1M

3,793 claims

$541.32

$1,188.30

0.5×

Normal range

E0784Normal range

External ambulatory infusion pump, insulin

$2.1M

3,793 claims · 10.5%

Your Cost: $541.32/claim|Median: $1,188.30

0.5× median

A9277Breath alcohol test, per administrationSee all providers →

$2.0M

3,723 claims

$549.00

$407.76

1.3×

Top 25%

A9277Top 25%

Breath alcohol test, per administration

$2.0M

3,723 claims · 10.4%

Your Cost: $549.00/claim|Median: $407.76

1.3× median

A9278 See all providers →

$543K

1,090 claims

$498.52

$366.50

1.4×

Top 25%

A9278Top 25%

$543K

1,090 claims · 2.8%

Your Cost: $498.52/claim|Median: $366.50

1.4× median

A4230Infusion supplies, non-chemotherapy, per visitSee all providers →

$399K

2,943 claims

$135.61

$136.09

1.0×

Normal range

A4230Normal range

Infusion supplies, non-chemotherapy, per visit

$399K

2,943 claims · 2.0%

Your Cost: $135.61/claim|Median: $136.09

1.0× median

A4232 See all providers →

$96K

2,817 claims

$34.25

$34.49

1.0×

Normal range

A4232Normal range

$96K

2,817 claims · 0.5%

Your Cost: $34.25/claim|Median: $34.49

1.0× median

A6257 See all providers →

$20K

1,187 claims

$16.83

$10.48

1.6×

Normal range

A6257Normal range

$20K

1,187 claims · 0.1%

Your Cost: $16.83/claim|Median: $10.48

1.6× median

A5120 See all providers →

$6K

1,211 claims

$4.71

$6.35

0.7×

Normal range

A5120Normal range

$6K

1,211 claims · 0.0%

Your Cost: $4.71/claim|Median: $6.35

0.7× median

A4362 See all providers →

$2K

60 claims

$27.39

$36.03

0.8×

Normal range

A4362Normal range

$2K

60 claims · 0.0%

Your Cost: $27.39/claim|Median: $36.03

0.8× median

A4225 See all providers →

$1K

51 claims

$25.81

$22.71

1.1×

Normal range

A4225Normal range

$1K

51 claims · 0.0%

Your Cost: $25.81/claim|Median: $22.71

1.1× median

A4456 See all providers →

$609

171 claims

$3.56

$6.74

0.5×

Normal range

A4456Normal range

$609

171 claims · 0.0%

Your Cost: $3.56/claim|Median: $6.74

0.5× median

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