Stella Orton Home Care Agency Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $250.07 per claim for T1019 (Personal care services, per 15 min), which is 3.0× the national median of $82.47.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T1020 (2 unique codes).
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Extreme procedure concentration — 84% of all billing flows through just 2 codes (T1019, T1020).
Bills $250.07 per claim for T1019 (Personal care services, per 15 min) — 3.0× the national median of $82.47.
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $203.2M is at the 50th percentile among 322 Home Health providers.
Extreme procedure concentration — 84% of $203.2M billed through just 2 codes
Total Paid
$203.2M
$203,245,563
Total Claims
783K
Beneficiaries
32K
24.6 claims/patient
Avg Cost/Claim
$259
#444 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Stella Orton Home Care Agency Inc. is a Home Health provider based in Staten Island, NY. From the 2018–2024 period, this provider received $203.2M in Medicaid payments across 783K claims.
Why This Matters
This provider received $203.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,405 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 2 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 84% of total spending.
$170.4M
682K claims
$250.07
$82.47
Personal care services, per 15 min
$170.4M
682K claims · 83.9%
$32.8M
102K claims
$322.48
$296.27
Personal care services, per diem
$32.8M
102K claims · 16.1%
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