Unknown Provider A430617100
NPI: A430617100
Risk Tier
Elevated
Total Paid
$139.8M
$139,780,634
Total Claims
2.2M
Beneficiaries
62K
Avg Cost/Claim
$63.30
Active billing period: 22 months (2018-01 to 2019-10)
Statistical Risk Flags (1)
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T1019 (2 unique codes).
Advanced Detection Signals
Billing Velocity
4562.2 claims per working day — may exceed physically possible volume for a single provider.
Suspicious Concentration
Herfindahl-Hirschman Index of 1 across 2 procedure codes — billing is highly concentrated in very few services.
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