Is GREATER ROCHESTER HEALTH HOME NETWORK, LLC flagged for Medicaid fraud?

GREATER ROCHESTER HEALTH HOME NETWORK, LLC (NPI: 1740554229) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does GREATER ROCHESTER HEALTH HOME NETWORK, LLC bill Medicaid?

GREATER ROCHESTER HEALTH HOME NETWORK, LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Case Management provider. Located in ROCHESTER, NY.

What is NPI 1740554229?

NPI 1740554229 is the National Provider Identifier for GREATER ROCHESTER HEALTH HOME NETWORK, LLC. They are a Case Management provider based in ROCHESTER, NY. This NPI is registered with the CMS NPI Registry.

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GREATER ROCHESTER HEALTH HOME NETWORK, LLC

Case Management·ROCHESTER, NY·NPI: 1740554229Share

Compared to Case Management Peers

Total spending distribution among 137 providers in this specialty

P25MedianP75P90

This provider's total spending of $81.0M is at the 25th percentile among 137 Case Management providers.

Active Billing Period:2018-07→2024-12(78 months)

Total Paid

$81.0M

$80,983,342

Total Claims

259K

Beneficiaries

259K

1.0 claims/patient

Avg Cost/Claim

$313

Monthly Spending Trend

Yearly Spending

2018

$106K

+3931%

2019

$4.3M

+273%

2020

$15.9M

-0%

2021

$15.9M

+4%

2022

$16.5M

-5%

2023

$15.7M

-21%

2024

$12.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 5 distinct procedure codes. The top code (G9005 (Coordinated care fee, risk-adjusted, ESRD)) accounts for 68% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

G9005Coordinated care fee, risk-adjusted, ESRDSee all providers →

$55.2M

165K claims

$333.80

$47.08

7.1×

Top 25%

G9005Top 25%

Coordinated care fee, risk-adjusted, ESRD

$55.2M

165K claims · 68.1%

Your Cost: $333.80/claim|Median: $47.08

7.1× median

T1016Case management, each 15 minSee all providers →

$23.7M

86K claims

$274.74

$49.62

5.5×

Top 10%

T1016Top 10%

Case management, each 15 min

$23.7M

86K claims · 29.2%

Your Cost: $274.74/claim|Median: $49.62

5.5× median

T2022Case management, per monthSee all providers →

$2.0M

5,099 claims

$386.05

$202.77

1.9×

Top 10%

T2022Top 10%

Case management, per month

$2.0M

5,099 claims · 2.4%

Your Cost: $386.05/claim|Median: $202.77

1.9× median

G9001 See all providers →

$140K

2,226 claims

$63.09

$53.98

1.2×

Normal range

G9001Normal range

$140K

2,226 claims · 0.2%

Your Cost: $63.09/claim|Median: $53.98

1.2× median

G0506Comprehensive assessment of chronic care managementSee all providers →

$21K

115 claims

$184.12

$7.41

24.8×

Top 5%

G0506Top 5%

Comprehensive assessment of chronic care management

$21K

115 claims · 0.0%

Your Cost: $184.12/claim|Median: $7.41

24.8× median

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