Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.6M (2019) to $28.8M (2020) — a 1664% swing with $27.2M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 7 procedure codes: 92507 at 2.0× median, S9123 at 4.7× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1664% from 2019 to 2020.
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
▼
Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
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.
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.
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.
Risk Assessment
Bills $582.04 per claim for S9123 (Nursing care, in the home, by RN, per 15 minutes) — 4.7× the national median of $124.86.
Bills $100.07 per claim for 97530 (Therapeutic activities, each 15 min) — 3.0× the national median of $33.11.
Bills $102.17 per claim for 97110 (Therapeutic exercises, each 15 min) — 4.2× the national median of $24.49.
Billing above the 90th percentile for 7 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $708.5M is at the 90th percentile among 322 Home Health providers.
Above 90th percentile for this specialty — higher spending than 289 of 322 peers
Total Paid
$708.5M
$708,513,856
Total Claims
1.6M
Beneficiaries
116K
14.0 claims/patient
Avg Cost/Claim
$436
#70 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Aoc TX LLC is a Home Health provider based in Sherman, TX. From the 2018–2024 period, this provider received $708.5M in Medicaid payments across 1.6M claims.
Why This Matters
This provider received $708.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 88,564 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 18 distinct procedure codes. The top code (T1000 (Private duty/independent nursing service(s))) accounts for 85% of total spending.
$603.0M
1.1M claims
$547.45
$402.76
Private duty/independent nursing service(s)
$603.0M
1.1M claims · 85.1%
$61.2M
145K claims
$421.79
$400.25
Nursing care, in the home; per hour
$61.2M
145K claims · 8.6%
Speech/hearing/language treatment
$14.3M
147K claims · 2.0%
$5.4M
9K claims
$582.04
$124.86
Nursing care, in the home, by RN, per 15 minutes
$5.4M
9K claims · 0.8%
Therapeutic activities, each 15 min
$5.3M
53K claims · 0.8%
Therapeutic exercises, each 15 min
$4.7M
46K claims · 0.7%
$4.4M
29K claims
$151.61
$71.40
Respite care services, per 15 minutes
$4.4M
29K claims · 0.6%
$4.0M
29K claims
$137.37
$96.24
Comprehensive community support services, per 15 min
$4.0M
29K claims · 0.6%
$2.6M
27K claims
$94.98
$82.34
Attendant care services, per 15 min
$2.6M
27K claims · 0.4%
$1.4M
21K claims
$67.45
$82.47
Personal care services, per 15 min
$1.4M
21K claims · 0.2%
$1.3M
10K claims
$122.86
$49.74
Treatment of swallowing dysfunction and/or oral function
$1.3M
10K claims · 0.2%
Speech therapy, re-evaluation
$398K
3K claims · 0.1%
$323K
2K claims
$161.17
$110.87
Evaluation of speech sound production with language comprehension
$323K
2K claims · 0.0%
OT re-evaluation
$96K
946 claims · 0.0%
PT re-evaluation
$83K
818 claims · 0.0%
$35K
422 claims
$83.02
$51.67
Skilled nursing services, home health, per visit, RN
$35K
422 claims · 0.0%
OT evaluation, moderate complexity
$3K
25 claims · 0.0%
PT evaluation, moderate complexity
$1K
13 claims · 0.0%
Other Top Providers in Texas
View all →Similar Providers
Other top providers in Home Health