Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Variety Children's Hospital

General Acute Care Hospital Children·Miami, FL·NPI: 1871540237SharePrint Report
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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:

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Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

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Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

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

Change PointBilling shifted 19.0x in 2018-11

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

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Bills $202.94 per claim for 99283 (Emergency dept visit, moderate complexity) — 4.8× the national median of $42.48.

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Bills $202.53 per claim for 92507 (Speech/hearing/language treatment) — 4.1× the national median of $49.45.

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Bills $239.22 per claim for 99284 (Emergency dept visit, high complexity) — 3.4× the national median of $69.51.

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Billing in the top 1% nationally for 9 procedure codes: 92507, 97530, 97110.

This is a statistical summary, not an accusation. See our methodology.

Compared to General Acute Care Hospital Children Peers

Total spending distribution among 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $175.3M is at the 25th percentile among 16 General Acute Care Hospital Children providers.

Active Billing Period:2018-01→2023-12(72 months)

Total Paid

$175.3M

$175,320,723

Total Claims

1.6M

Beneficiaries

1.3M

1.2 claims/patient

Avg Cost/Claim

$108

#557 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Variety Children's Hospital is a General Acute Care Hospital Children provider based in Miami, FL. From the 2018–2024 period, this provider received $175.3M in Medicaid payments across 1.6M claims.

Why This Matters

This provider received $175.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,915 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 474% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$4.9M
+840%
2019
$46.4M
-50%
2020
$23.3M
+69%
2021
$39.5M
-17%
2022
$32.9M
-14%
2023
$28.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 16% of total spending.

99283Top 5%

Emergency dept visit, moderate complexity

$28.5M

140K claims · 16.2%

Your Cost: $202.94/claim|Median: $42.48
4.8× median
92507Top 1%

Speech/hearing/language treatment

$14.7M

72K claims · 8.4%

Your Cost: $202.53/claim|Median: $49.45
4.1× median
99284Top 5%

Emergency dept visit, high complexity

$14.4M

60K claims · 8.2%

Your Cost: $239.22/claim|Median: $69.51
3.4× median
97530Top 1%

Therapeutic activities, each 15 min

$13.0M

71K claims · 7.4%

Your Cost: $183.31/claim|Median: $33.11
5.5× median
97110Top 1%

Therapeutic exercises, each 15 min

$10.3M

48K claims · 5.9%

Your Cost: $216.38/claim|Median: $24.49
8.8× median
99282Top 5%

Emergency dept visit, low complexity

$6.2M

32K claims · 3.5%

Your Cost: $191.68/claim|Median: $37.72
5.1× median
87804Top 1%

Influenza virus detection, rapid test

$4.2M

64K claims · 2.4%

Your Cost: $65.00/claim|Median: $12.59
5.2× median
G0378Normal range

Hospital observation service, per hour

$3.8M

28K claims · 2.2%

Your Cost: $133.68/claim|Median: $99.39
1.3× median
93306Top 1%

Echocardiography, transthoracic, complete, with Doppler

$3.3M

6K claims · 1.9%

Your Cost: $590.56/claim|Median: $54.68
10.8× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$2.8M

3K claims · 1.6%

Your Cost: $828.74/claim|Median: $763.43
1.1× median
87635Top 5%

COVID-19 SARS-CoV-2 amplified probe detection

$2.8M

38K claims · 1.6%

Your Cost: $73.47/claim|Median: $39.70
1.9× median
44970Normal range

$2.7M

947 claims · 1.5%

Your Cost: $2,839.02/claim|Median: $1,699.18
1.7× median
97112Top 1%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$2.7M

15K claims · 1.5%

Your Cost: $184.08/claim|Median: $20.04
9.2× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$2.4M

2K claims · 1.4%

Your Cost: $1,184.05/claim|Median: $1,587.53
0.8× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$2.3M

13K claims · 1.3%

Your Cost: $175.59/claim|Median: $85.65
2.0× median
99213Top 5%

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

$2.0M

15K claims · 1.2%

Your Cost: $139.25/claim|Median: $37.81
3.7× median
96365Top 5%

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$2.0M

11K claims · 1.1%

Your Cost: $186.74/claim|Median: $54.77
3.4× median
93303Top 5%

Echocardiography, transthoracic, limited

$1.6M

3K claims · 0.9%

Your Cost: $595.20/claim|Median: $112.83
5.3× median
71046Top 5%

Chest X-ray, 2 views

$1.4M

26K claims · 0.8%

Your Cost: $56.44/claim|Median: $8.92
6.3× median
70553Top 25%

MRI brain without contrast, then with contrast

$1.4M

5K claims · 0.8%

Your Cost: $289.80/claim|Median: $133.68
2.2× median
76775Top 5%

$1.4M

9K claims · 0.8%

Your Cost: $151.22/claim|Median: $28.03
5.4× median
92587Top 1%

$1.4M

6K claims · 0.8%

Your Cost: $236.09/claim|Median: $19.24
12.3× median
76705Top 25%

Ultrasound, abdominal, limited

$1.4M

15K claims · 0.8%

Your Cost: $88.65/claim|Median: $23.81
3.7× median
92526Top 10%

Treatment of swallowing dysfunction and/or oral function

$1.3M

13K claims · 0.7%

Your Cost: $102.30/claim|Median: $49.74
2.1× median
72082Top 10%

$1.3M

13K claims · 0.7%

Your Cost: $97.70/claim|Median: $31.02
3.1× median
84703Top 1%

Human chorionic gonadotropin (hCG) quantitative blood test

$1.1M

11K claims · 0.7%

Your Cost: $103.14/claim|Median: $4.20
24.6× median
87633Normal range

Respiratory virus detection, 12-25 targets, nucleic acid

$1.1M

7K claims · 0.7%

Your Cost: $156.90/claim|Median: $169.17
0.9× median
96374Top 10%

Therapeutic/prophylactic/diagnostic IV push, single substance

$1.1M

10K claims · 0.6%

Your Cost: $112.07/claim|Median: $21.76
5.2× median
96372Top 1%

Therapeutic injection, subcutaneous/intramuscular

$1.1M

9K claims · 0.6%

Your Cost: $127.40/claim|Median: $9.56
13.3× median
99214Normal range

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

$1.1M

21K claims · 0.6%

Your Cost: $53.72/claim|Median: $53.41
1.0× median

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Similar Providers

Other top providers in General Acute Care Hospital Children

Children's Hospital Medical Center of Akron

Akron, OH

$556.6M

Phoenix Children's Hospital

Phoenix, AZ

$555.7M

Childrens Hospital of Philadelphia

Philadelphia, PA

$286.9M

Cook Children's Medical Center

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$286.7M

Texas Children's Hospital

Houston, TX

$277.3M

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