Mississippi Department of Rehabilitaion Svs
Case Management
Jackson, Mississippi
NPI: 1770795536
Risk Tier
Critical
Total Paid
$317.2M
$317,166,187
Total Claims
782K
Beneficiaries
309K
Avg Cost/Claim
$405.54
Active billing period: 83 months (2018-01 to 2024-11)
Statistical Fraud Flags (3)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $468.59 per claim for S5125 (Attendant care services, per 15 min), which is 5.7× the national median of $82.34.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: S5125 at 5.7× median, S5165 at 4.1× median.
Consistent Billing
Monthly billing amounts show almost no natural variation (CV < 0.1).
Monthly billing coefficient of variation: 0.0679 (near-zero variation).
Advanced Detection Signals
Benford's Law Anomaly
Chi-squared statistic of 2.5 — the distribution of leading digits in billing amounts deviates significantly from the expected natural pattern.
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