Baltimore Medical System INC
Clinic/Center Federally Qualified Health Center (FQHC)
Baltimore, Maryland
NPI: 1548266547
Risk Tier
Critical
Total Paid
$121.2M
$121,188,457
Total Claims
958K
Beneficiaries
794K
Avg Cost/Claim
$126.56
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (4)
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.9M (2019) to $22.8M (2020) — a 1104% swing with $20.9M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1104% from 2019 to 2020.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Spending Spike
Experienced a dramatic increase in billing over a short period.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 12.6x in 2019-12 — a statistically significant structural change in billing behavior was detected.
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