Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.0M (2018) to $17.9M (2019) — a 1606% swing with $16.9M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1606% from 2018 to 2019.
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:
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.
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
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $371.67 per claim for S5131 (Homemaker service, NOS, per diem) — 3.6× the national median of $102.01.
Bills $70.92 per claim for T2003 (Non-emergency transport; encounter/trip) — 3.3× the national median of $21.70.
Bills $79.81 per claim for A0090 (Non-emergency transport, per mile) — 7.6× the national median of $10.45.
Billing above the 90th percentile for 7 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Unknown Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $175.8M is at the 99th percentile among 8 Unknown providers.
Above 99th percentile for this specialty — higher spending than 7 of 8 peers
Total Paid
$175.8M
$175,814,218
Total Claims
7.9M
Beneficiaries
994K
7.9 claims/patient
Avg Cost/Claim
$22
#553 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Not Found is a Unknown provider based in Unknown, Unknown. From the 2018–2024 period, this provider received $175.8M in Medicaid payments across 7.9M claims.
Why This Matters
This provider received $175.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,976 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 (A0100 (Non-emergency transportation; per trip)) accounts for 40% of total spending.
$70.6M
3.7M claims
$19.33
$24.72
Non-emergency transportation; per trip
$70.6M
3.7M claims · 40.2%
$40.0M
2.7M claims
$14.66
$21.33
Non-invasive prenatal screening, fetal chromosomal abnormalities
$40.0M
2.7M claims · 22.7%
$13.1M
350K claims
$37.35
$29.37
Non-emergency wheelchair van transport
$13.1M
350K claims · 7.4%
Homemaker service, NOS, per diem
$7.1M
19K claims · 4.0%
$6.1M
85K claims
$70.92
$21.70
Non-emergency transport; encounter/trip
$6.1M
85K claims · 3.4%
Non-emergency transport, per mile
$5.0M
62K claims · 2.8%
Homemaker service, NOS; per 15 min
$4.5M
24K claims · 2.5%
$4.4M
277K claims
$16.06
$18.24
Outpatient psychiatric services, partial hospitalization, per hour
$4.4M
277K claims · 2.5%
$3.7M
279K claims
$13.12
$19.89
Homemaker service, NOS, per diem
$3.7M
279K claims · 2.1%
$3.0M
15K claims
$195.93
$132.60
Non-emergency transportation, per diem
$3.0M
15K claims · 1.7%
Laundry service, per occasion
$2.2M
42K claims · 1.3%
$1.8M
14K claims · 1.0%
Foster care, adult; per diem
$1.2M
4K claims · 0.7%
$1.1M
10K claims
$109.05
$111.06
Attendant care services, in-home, per 15 min
$1.1M
10K claims · 0.6%
Day care services, adult; per 15 min
$1.0M
4K claims · 0.6%
$946K
38K claims
$24.85
$29.97
Emergency response system, per month
$946K
38K claims · 0.5%
$715K
12K claims
$57.96
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$715K
12K claims · 0.4%
$711K
6K claims
$123.36
$82.47
Personal care services, per 15 min
$711K
6K claims · 0.4%
$695K
3K claims
$230.72
$58.05
Ambulance service, BLS, non-emergency transport
$695K
3K claims · 0.4%
Non-emergency taxi transport
$660K
11K claims · 0.4%
Companion care, adult, per diem
$528K
3K claims · 0.3%
$525K
9K claims
$56.02
$19.56
Transportation waiting time, air ambulance/rotary wing
$525K
9K claims · 0.3%
$505K
4K claims · 0.3%
$443K
27K claims
$16.54
$85.02
Mental health services, not otherwise specified
$443K
27K claims · 0.3%
$358K
5K claims
$68.23
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$358K
5K claims · 0.2%
$314K
33K claims
$9.64
$19.61
Non-emergency transportation, patient attendant or aide
$314K
33K claims · 0.2%
$301K
15K claims · 0.2%
Home health aide services, per visit
$290K
664 claims · 0.2%
$283K
117 claims · 0.2%
$256K
2K claims
$123.46
$48.38
Medical home program, comprehensive care management
$256K
2K claims · 0.1%