Government of the District of Columbia Office of Tax and Revenue
Ambulance Land Transport
Washington, District of Columbia
NPI: 1992805022
Risk Tier
High
Total Paid
$213.4M
$213,401,879
Total Claims
644K
Beneficiaries
520K
Avg Cost/Claim
$331.43
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $674.25 per claim for A0427 (Ambulance, ALS emergency transport Level 1), which is 4.1× the national median of $164.22.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: A0429 at 4.3× median, A0427 at 4.1× median.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 4.5x in 2021-04 — a statistically significant structural change in billing behavior was detected.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024