Childrens Hospital of the Kings Daughters INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 182 procedure codes: 92507 at 2.6× median, 99283 at 4.5× 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.
Risk Assessment
Bills $192.17 per claim for 99283 (Emergency dept visit, moderate complexity) — 4.5× the national median of $42.48.
Bills $138.68 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity) — 3.7× the national median of $37.81.
Bills $303.56 per claim for 99284 (Emergency dept visit, high complexity) — 4.4× the national median of $69.51.
Billing in the top 1% nationally for 2 procedure codes: 99211, 93306.
This is a statistical summary, not an accusation. See our methodology.
Compared to Social Worker, Clinical Peers
Total spending distribution among 34 providers in this specialty
This provider's total spending of $288.2M is at the 99th percentile among 34 Social Worker, Clinical providers.
Above 99th percentile for this specialty — higher spending than 33 of 34 peers
Total Paid
$288.2M
$288,158,032
Total Claims
3.7M
Beneficiaries
3.0M
1.3 claims/patient
Avg Cost/Claim
$77
#259 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Childrens Hospital of the Kings Daughters INC is a Social Worker, Clinical provider based in Norfolk, VA. From the 2018–2024 period, this provider received $288.2M in Medicaid payments across 3.7M claims.
Why This Matters
This provider received $288.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 36,019 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 (92507 (Speech/hearing/language treatment)) accounts for 8% of total spending.
Speech/hearing/language treatment
$23.8M
186K claims · 8.2%
$22.2M
116K claims
$192.17
$42.48
Emergency dept visit, moderate complexity
$22.2M
116K claims · 7.7%
$19.2M
139K claims
$138.68
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$19.2M
139K claims · 6.7%
$12.4M
137K claims
$90.93
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$12.4M
137K claims · 4.3%
$10.8M
35K claims
$303.56
$69.51
Emergency dept visit, high complexity
$10.8M
35K claims · 3.7%
$10.5M
53K claims
$199.91
$25.06
Office/outpatient visit, low complexity
$10.5M
53K claims · 3.6%
Therapeutic exercises, each 15 min
$9.6M
128K claims · 3.3%
$9.3M
26K claims
$358.19
$85.65
Emergency dept visit, high/urgent complexity
$9.3M
26K claims · 3.2%
Therapeutic activities, each 15 min
$7.4M
110K claims · 2.6%
Emergency dept visit, low complexity
$7.0M
40K claims · 2.4%
$7.0M
4K claims
$1,716.30
$763.43
Unlisted procedure, dentoalveolar structures
$7.0M
4K claims · 2.4%
$6.4M
30K claims
$215.33
$12.93
Office/outpatient visit, minimal complexity
$6.4M
30K claims · 2.2%
$4.8M
2K claims
$2,145.18
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$4.8M
2K claims · 1.7%
$4.4M
5K claims
$947.67
$233.73
Polysomnography, sleep study, 6+ hours
$4.4M
5K claims · 1.5%
$4.3M
2K claims
$1,977.59
$331.68
Tonsillectomy and adenoidectomy, under age 12
$4.3M
2K claims · 1.5%
$4.3M
7K claims
$645.45
$54.68
Echocardiography, transthoracic, complete, with Doppler
$4.3M
7K claims · 1.5%
Upper GI endoscopy with biopsy
$4.1M
5K claims · 1.4%
Tympanostomy, general anesthesia
$4.0M
3K claims · 1.4%
$3.9M
9K claims · 1.4%
$3.8M
10K claims
$364.54
$38.92
IV infusion, hydration, each additional hour
$3.8M
10K claims · 1.3%
$3.8M
1K claims · 1.3%
$3.6M
12K claims
$288.62
$99.39
Hospital observation service, per hour
$3.6M
12K claims · 1.2%
$2.9M
3K claims · 1.0%
$2.6M
38K claims
$70.16
$10.88
Pressurized or nonpressurized inhalation treatment
$2.6M
38K claims · 0.9%
MRI brain without contrast
$2.5M
5K claims · 0.9%
$2.5M
1K claims · 0.9%
$2.4M
24K claims
$102.63
$57.85
Office/outpatient visit, new patient, low-mod complexity
$2.4M
24K claims · 0.8%
$2.3M
1K claims · 0.8%
$2.0M
36K claims
$55.78
$63.08
Infectious disease detection (COVID-19)
$2.0M
36K claims · 0.7%
Ultrasound, retroperitoneal, complete
$2.0M
10K claims · 0.7%
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