The Health and Hospital Corporation of Marion County
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 84 procedure codes: 99283 at 3.8× median, 99282 at 4.1× 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:
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 $163.48 per claim for 99283 (Emergency dept visit, moderate complexity) — 3.9× the national median of $42.48.
Bills $154.36 per claim for 99282 (Emergency dept visit, low complexity) — 4.1× the national median of $37.72.
Bills $89.76 per claim for 99212 (Office/outpatient visit, low complexity) — 3.6× the national median of $25.06.
Billing in the top 1% nationally for 5 procedure codes: 71046, 45385, 94760.
This is a statistical summary, not an accusation. See our methodology.
Compared to Psychiatric Unit Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $231.5M is at the 75th percentile among 8 Psychiatric Unit providers.
Total Paid
$231.5M
$231,531,116
Total Claims
3.5M
Beneficiaries
2.7M
1.3 claims/patient
Avg Cost/Claim
$67
#363 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
The Health and Hospital Corporation of Marion County is a Psychiatric Unit provider based in Indianapolis, IN. From the 2018–2024 period, this provider received $231.5M in Medicaid payments across 3.5M claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $231.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 28,941 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 (A0429 (Ambulance, BLS emergency transport)) accounts for 19% of total spending.
$44.4M
236K claims
$188.69
$138.19
Ambulance, BLS emergency transport
$44.4M
236K claims · 19.2%
$28.0M
129K claims
$217.52
$164.22
Ambulance, ALS emergency transport Level 1
$28.0M
129K claims · 12.1%
$23.1M
141K claims
$163.48
$42.48
Emergency dept visit, moderate complexity
$23.1M
141K claims · 10.0%
$13.1M
85K claims
$154.36
$37.72
Emergency dept visit, low complexity
$13.1M
85K claims · 5.7%
$12.9M
143K claims
$89.76
$25.06
Office/outpatient visit, low complexity
$12.9M
143K claims · 5.6%
$12.3M
79K claims
$156.24
$69.51
Emergency dept visit, high complexity
$12.3M
79K claims · 5.3%
Hospital outpatient clinic visit
$8.9M
131K claims · 3.9%
$7.8M
380K claims
$20.64
$23.36
Ground mileage, per statute mile
$7.8M
380K claims · 3.4%
$6.4M
94K claims
$68.36
$7.50
Electrocardiogram, tracing only, without interpretation
$6.4M
94K claims · 2.8%
Chest X-ray, 2 views
$6.4M
52K claims · 2.8%
$6.2M
4K claims
$1,554.12
$255.17
Colonoscopy with polyp removal, snare technique
$6.2M
4K claims · 2.7%
Psychotherapy, 60 minutes
$5.6M
61K claims · 2.4%
Psychotherapy, 45 minutes
$4.1M
46K claims · 1.8%
$3.5M
10K claims · 1.5%
$3.2M
26K claims
$121.49
$85.65
Emergency dept visit, high/urgent complexity
$3.2M
26K claims · 1.4%
Psychotherapy, 30 minutes
$2.3M
26K claims · 1.0%
CT abdomen and pelvis with contrast
$2.1M
6K claims · 0.9%
$2.1M
30K claims
$70.24
$0.79
Pulse oximetry, single reading, noninvasive
$2.1M
30K claims · 0.9%
$1.9M
30K claims · 0.8%
$1.7M
38K claims
$46.11
$35.43
Drug test, presumptive, by chemistry analyzers
$1.7M
38K claims · 0.7%
$1.7M
416 claims
$4,165.81
$5,391.55
Injection, pembrolizumab, 1 mg
$1.7M
416 claims · 0.7%
$1.7M
2K claims
$739.42
$786.43
Etonogestrel implant system, including implant and supplies
$1.7M
2K claims · 0.7%
$1.5M
17K claims
$89.97
$99.21
Psychiatric diagnostic evaluation
$1.5M
17K claims · 0.7%
$1.3M
27K claims
$50.57
$38.79
Infectious agent detection, amplified probe, multiple organisms
$1.3M
27K claims · 0.6%
$1.3M
11K claims
$111.06
$74.09
Office/outpatient visit, high complexity
$1.3M
11K claims · 0.5%
$1.1M
3K claims
$424.92
$39.96
Initial hospital care, straightforward/low
$1.1M
3K claims · 0.5%
$873K
5K claims
$176.27
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$873K
5K claims · 0.4%
$848K
32K claims
$26.41
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$848K
32K claims · 0.4%
Chest X-ray, single view
$847K
6K claims · 0.4%
$845K
32K claims
$26.36
$24.95
Chlamydia detection, nucleic acid, amplified probe
$845K
32K claims · 0.4%
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