Is CITRUS HEALTH NETWORK INC flagged for Medicaid fraud?

CITRUS HEALTH NETWORK INC (NPI: 1821138819) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does CITRUS HEALTH NETWORK INC bill Medicaid?

CITRUS HEALTH NETWORK INC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in HIALEAH, FL.

What is NPI 1821138819?

NPI 1821138819 is the National Provider Identifier for CITRUS HEALTH NETWORK INC. They are a Community/Behavioral Health provider based in HIALEAH, FL. This NPI is registered with the CMS NPI Registry.

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CITRUS HEALTH NETWORK INC

Community/Behavioral Health·HIALEAH, FL·NPI: 1821138819Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $50.8M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$50.8M

$50,751,904

Total Claims

915K

Beneficiaries

331K

2.8 claims/patient

Avg Cost/Claim

$55

Monthly Spending Trend

Yearly Spending

2018

$1.3M

+619%

2019

$9.4M

+5%

2020

$9.8M

-21%

2021

$7.8M

-12%

2022

$6.8M

+17%

2023

$8.0M

-3%

2024

$7.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (H2017 (Psychosocial rehabilitation services, per 15 min)) accounts for 29% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$14.7M

226K claims

$65.23

$91.63

0.7×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$14.7M

226K claims · 29.0%

Your Cost: $65.23/claim|Median: $91.63

0.7× median

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$10.3M

190K claims

$54.37

$121.16

0.4×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$10.3M

190K claims · 20.3%

Your Cost: $54.37/claim|Median: $121.16

0.4× median

T1017Targeted case management, per 15 minSee all providers →

$10.3M

167K claims

$61.42

$69.56

0.9×

Normal range

T1017Normal range

Targeted case management, per 15 min

$10.3M

167K claims · 20.3%

Your Cost: $61.42/claim|Median: $69.56

0.9× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$4.7M

66K claims

$70.24

$84.12

0.8×

Normal range

H2019Normal range

Therapeutic behavioral services, per 15 min

$4.7M

66K claims · 9.2%

Your Cost: $70.24/claim|Median: $84.12

0.8× median

H0040Assertive community treatment, face-to-face, per 15 minutesSee all providers →

$3.7M

146K claims

$25.24

$266.41

0.1×

Normal range

H0040Normal range

Assertive community treatment, face-to-face, per 15 minutes

$3.7M

146K claims · 7.3%

Your Cost: $25.24/claim|Median: $266.41

0.1× median

H0032Mental health service plan developmentSee all providers →

$2.3M

37K claims

$63.33

$80.64

0.8×

Normal range

H0032Normal range

Mental health service plan development

$2.3M

37K claims · 4.6%

Your Cost: $63.33/claim|Median: $80.64

0.8× median

S5145Foster care, therapeutic, child, per diemSee all providers →

$2.1M

19K claims

$111.40

$216.31

0.5×

Normal range

S5145Normal range

Foster care, therapeutic, child, per diem

$2.1M

19K claims · 4.2%

Your Cost: $111.40/claim|Median: $216.31

0.5× median

H2000Comprehensive multidisciplinary evaluationSee all providers →

$1.0M

5,903 claims

$173.87

$114.71

1.5×

Top 25%

H2000Top 25%

Comprehensive multidisciplinary evaluation

$1.0M

5,903 claims · 2.0%

Your Cost: $173.87/claim|Median: $114.71

1.5× median

H0031Mental health assessment by non-physicianSee all providers →

$947K

41K claims

$23.06

$96.18

0.2×

Normal range

H0031Normal range

Mental health assessment by non-physician

$947K

41K claims · 1.9%

Your Cost: $23.06/claim|Median: $96.18

0.2× median

H2030Mental health clubhouse services, per 15 minutesSee all providers →

$640K

17K claims

$38.34

$73.58

0.5×

Normal range

H2030Normal range

Mental health clubhouse services, per 15 minutes

$640K

17K claims · 1.3%

Your Cost: $38.34/claim|Median: $73.58

0.5× median

H2010Comprehensive medication services, per 15 minSee all providers →

$5K

258 claims

$18.02

$62.69

0.3×

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

$5K

258 claims · 0.0%

Your Cost: $18.02/claim|Median: $62.69

0.3× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$4K

183 claims

$23.64

$37.81

0.6×

Normal range

99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$4K

183 claims · 0.0%

Your Cost: $23.64/claim|Median: $37.81

0.6× median

H0046Mental health services, not otherwise specifiedSee all providers →

$540

36 claims

$15.00

$85.02

0.2×

Normal range

H0046Normal range

Mental health services, not otherwise specified

$540

36 claims · 0.0%

Your Cost: $15.00/claim|Median: $85.02

0.2× median

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