Is SPECTRUM COMMUNITY HEALTH, INC. flagged for Medicaid fraud?

SPECTRUM COMMUNITY HEALTH, INC. (NPI: 1881767069) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does SPECTRUM COMMUNITY HEALTH, INC. bill Medicaid?

SPECTRUM COMMUNITY HEALTH, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Home Health provider. Located in VIRGINIA, MN.

What is NPI 1881767069?

NPI 1881767069 is the National Provider Identifier for SPECTRUM COMMUNITY HEALTH, INC.. They are a Home Health provider based in VIRGINIA, MN. This NPI is registered with the CMS NPI Registry.

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SPECTRUM COMMUNITY HEALTH, INC.

Home Health·VIRGINIA, MN·NPI: 1881767069Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $31.4M is at the below 25th percentile among 322 Home Health providers.

Active Billing Period:2018-01→2024-03(75 months)

Billing appears to have stoppedLast active: 2024-03

Total Paid

$31.4M

$31,371,025

Total Claims

374K

Beneficiaries

19K

19.8 claims/patient

Avg Cost/Claim

$84

Monthly Spending Trend

Yearly Spending

2018

$2.7M

+142%

2019

$6.6M

-1%

2020

$6.5M

-12%

2021

$5.7M

-3%

2022

$5.6M

-25%

2023

$4.2M

-97%

2024

$127K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 6 distinct procedure codes. The top code (T2031 (Waiver services, not otherwise specified)) accounts for 96% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2031Waiver services, not otherwise specifiedSee all providers →

$30.3M

351K claims

$86.23

$853.15

0.1×

Normal range

T2031Normal range

Waiver services, not otherwise specified

$30.3M

351K claims · 96.5%

Your Cost: $86.23/claim|Median: $853.15

0.1× median

T1030Nursing care, in the home, by RN, per diemSee all providers →

$712K

11K claims

$63.93

$85.62

0.7×

Normal range

T1030Normal range

Nursing care, in the home, by RN, per diem

$712K

11K claims · 2.3%

Your Cost: $63.93/claim|Median: $85.62

0.7× median

S5130Homemaker service, NOS; per 15 minSee all providers →

$269K

11K claims

$25.32

$48.76

0.5×

Normal range

S5130Normal range

Homemaker service, NOS; per 15 min

$269K

11K claims · 0.9%

Your Cost: $25.32/claim|Median: $48.76

0.5× median

T1031Nursing care, in the home, by LPN, per diemSee all providers →

$92K

1,154 claims

$79.37

$80.56

1.0×

Normal range

T1031Normal range

Nursing care, in the home, by LPN, per diem

$92K

1,154 claims · 0.3%

Your Cost: $79.37/claim|Median: $80.56

1.0× median

S5161Emergency response system, per monthSee all providers →

$26K

421 claims

$61.37

$29.97

2.0×

Top 5%

S5161Top 5%

Emergency response system, per month

$26K

421 claims · 0.1%

Your Cost: $61.37/claim|Median: $29.97

2.0× median

T1021Home health aide visit, per 15 minSee all providers →

$5K

77 claims

$63.13

$44.79

1.4×

Normal range

T1021Normal range

Home health aide visit, per 15 min

$5K

77 claims · 0.0%

Your Cost: $63.13/claim|Median: $44.79

1.4× median

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