Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

DC#35 of 49 states

District of Columbia Medicaid Spending

District of Columbia's Medicaid program paid $1.25B across 6 providers from 2018–2024. 10 providers in District of Columbia are flagged on our risk watchlist. The top procedure code is T1019 (Personal care services, per 15 min) at $190.6M.

Total Spending

$1.25B

Total Claims

11.2M

Top Providers

6

Beneficiaries

6.7M

Largest Provider

Mbi Health Services LLC

$270.1M

Top Procedure

T1019

$190.6M

Flagged Providers

10

on risk watchlist

Avg Per Provider

$207.9M

across 6 providers

Yearly Spending Trend

Spending by Top Procedures

T1019Personal care services, per 15 min$190.6M
H0036Community psychiatric supportive treatment, per 15 min$137.9M
A0429Ambulance, BLS emergency transport$135.6M
99212Office/outpatient visit, low complexity$67.6M
A0427Ambulance, ALS emergency transport Level 1$66.6M

Top Procedures in District of Columbia

CodeTotal Paid
T1019

Personal care services, per 15 min

$190.6M
H0036

Community psychiatric supportive treatment, per 15 min

$137.9M
A0429

Ambulance, BLS emergency transport

$135.6M
99212

Office/outpatient visit, low complexity

$67.6M
A0427

Ambulance, ALS emergency transport Level 1

$66.6M
99283

Emergency dept visit, moderate complexity

$65.2M
99284

Emergency dept visit, high complexity

$40.4M
H0039

Assertive community treatment, per diem

$34.4M
96361

IV infusion, hydration, each additional hour

$28.1M
99285

Emergency dept visit, high/urgent complexity

$22.9M
99213

Office/outpatient visit, est. patient, low-mod complexity

$22.0M
97110

Therapeutic exercises, each 15 min

$19.0M
G0463

Hospital outpatient clinic visit

$18.4M
T2016

Habilitation, residential, waiver; per diem

$17.5M
99214

Office/outpatient visit, est. patient, mod-high complexity

$14.2M