Natera Inc.
Clinical Medical Laboratory
San Carlos, California
NPI: 1558672279
Risk Tier
Critical
Total Paid
$641.5M
$641,511,860
Total Claims
7.3M
Beneficiaries
6.4M
Avg Cost/Claim
$88.39
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (3)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: 81479 at 7.2× median, 0060U at 1.8× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Advanced Detection Signals
Billing Velocity
3927.3 claims per working day — may exceed physically possible volume for a single provider.
CUSUM Change Point
Billing shifted 3.7x in 2021-05 — 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