Ashland Hospital Corporation
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 134 procedure codes: 99284 at 2.8× median, 74177 at 6.3× median.
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:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $413.26 per claim for 74177 (CT abdomen and pelvis with contrast) — 6.3× the national median of $65.76.
Bills $404.78 per claim for 78452 (Myocardial perfusion imaging, SPECT, multiple studies) — 3.8× the national median of $106.14.
Bills $298.20 per claim for 74176 (CT abdomen and pelvis without contrast) — 5.0× the national median of $60.19.
Billing above the 90th percentile for 6 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$222.8M
$222,763,655
Total Claims
6.5M
Beneficiaries
5.0M
1.3 claims/patient
Avg Cost/Claim
$34
#381 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Ashland Hospital Corporation is a Clinic/Center, Rural Health provider based in Ashland, KY. From the 2018–2024 period, this provider received $222.8M in Medicaid payments across 6.5M claims.
Why This Matters
This provider received $222.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,845 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 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 11% of total spending.
$24.5M
801K claims
$30.59
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$24.5M
801K claims · 11.0%
$17.8M
500K claims
$35.66
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$17.8M
500K claims · 8.0%
$10.5M
153K claims
$68.84
$63.08
Infectious disease detection (COVID-19)
$10.5M
153K claims · 4.7%
$9.5M
49K claims
$193.53
$69.51
Emergency dept visit, high complexity
$9.5M
49K claims · 4.3%
$7.5M
62K claims
$122.03
$42.48
Emergency dept visit, moderate complexity
$7.5M
62K claims · 3.4%
$6.2M
36K claims
$174.44
$85.65
Emergency dept visit, high/urgent complexity
$6.2M
36K claims · 2.8%
$5.8M
359K claims
$16.18
$26.41
Hospital outpatient clinic visit
$5.8M
359K claims · 2.6%
CT abdomen and pelvis with contrast
$4.1M
10K claims · 1.8%
$4.0M
10K claims
$404.78
$106.14
Myocardial perfusion imaging, SPECT, multiple studies
$4.0M
10K claims · 1.8%
Upper GI endoscopy with biopsy
$3.8M
10K claims · 1.7%
$3.4M
12K claims
$298.20
$60.19
CT abdomen and pelvis without contrast
$3.4M
12K claims · 1.5%
$3.2M
12K claims
$269.79
$54.68
Echocardiography, transthoracic, complete, with Doppler
$3.2M
12K claims · 1.4%
$2.7M
2K claims · 1.2%
$2.7M
4K claims
$672.30
$183.33
Left heart catheterization with imaging
$2.7M
4K claims · 1.2%
$2.2M
14K claims
$153.80
$99.39
Hospital observation service, per hour
$2.2M
14K claims · 1.0%
Emergency dept visit, low complexity
$2.2M
18K claims · 1.0%
$2.2M
119K claims
$18.23
$15.76
Infectious disease detection, COVID-19, antigen
$2.2M
119K claims · 1.0%
Injection, omalizumab, 5 mg
$2.1M
5K claims · 1.0%
Comprehensive metabolic panel
$2.1M
290K claims · 0.9%
Chest X-ray, 2 views
$2.0M
47K claims · 0.9%
CT head/brain without contrast
$1.8M
11K claims · 0.8%
MRI lumbar spine without contrast
$1.7M
5K claims · 0.8%
$1.7M
29K claims
$59.61
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$1.7M
29K claims · 0.8%
Colonoscopy with biopsy
$1.7M
4K claims · 0.8%
Tympanostomy, general anesthesia
$1.5M
2K claims · 0.7%
General health panel
$1.4M
26K claims · 0.6%
$1.4M
3K claims
$552.54
$255.17
Colonoscopy with polyp removal, snare technique
$1.4M
3K claims · 0.6%
$1.3M
3K claims
$431.79
$133.68
MRI brain without contrast, then with contrast
$1.3M
3K claims · 0.6%
$1.3M
32K claims
$40.46
$35.43
Drug test, presumptive, by chemistry analyzers
$1.3M
32K claims · 0.6%
$1.3M
42K claims
$30.15
$57.85
Office/outpatient visit, new patient, low-mod complexity
$1.3M
42K claims · 0.6%
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