Physicians Group Laboratories, LLC
Clinical Medical Laboratory
Houma, Louisiana
NPI: 1760897755
Risk Tier
High
Total Paid
$208.1M
$208,133,531
Total Claims
4.6M
Beneficiaries
3.8M
Avg Cost/Claim
$45.06
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $13.2M (2019) to $43.6M (2020) — a 230% swing with $30.4M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: 87150 at 7.8× median, 87498 at 2.7× median.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 3.2x in 2020-05 — 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