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

WV#31 of 49 states

West Virginia Medicaid Spending

West Virginia's Medicaid program paid $1.56B across 9 providers from 2018–2024. 11 providers in West Virginia are flagged on our risk watchlist. The top procedure code is S5125 (Attendant care services, per 15 min) at $597.1M.

Total Spending

$1.56B

Total Claims

20.4M

Top Providers

9

Beneficiaries

16.6M

Largest Provider

Rem Community Options Inc.

$224.9M

Top Procedure

S5125

$597.1M

Flagged Providers

11

on risk watchlist

Avg Per Provider

$173.5M

across 9 providers

Yearly Spending Trend

Spending by Top Procedures

S5125Attendant care services, per 15 min$597.1M
T1019Personal care services, per 15 min$170.7M
87491Chlamydia detection, nucleic acid, amplified probe$51.0M
87591Neisseria gonorrhoeae detection, nucleic acid, amplified probe$50.5M
99285Emergency dept visit, high/urgent complexity$37.9M

Top Procedures in West Virginia

CodeTotal Paid
S5125

Attendant care services, per 15 min

$597.1M
T1019

Personal care services, per 15 min

$170.7M
87491

Chlamydia detection, nucleic acid, amplified probe

$51.0M
87591

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$50.5M
99285

Emergency dept visit, high/urgent complexity

$37.9M
99284

Emergency dept visit, high complexity

$30.1M
87661

Trichomonas vaginalis detection, nucleic acid, amplified probe

$28.8M
99214

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

$28.4M
99213

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

$24.2M
87798

Infectious agent detection, nucleic acid, not otherwise specified

$19.7M
87801

Infectious agent detection, amplified probe, multiple organisms

$19.2M
T2021

Day habilitation, waiver; per 15 min

$19.0M
88175

Cytopathology, cervical or vaginal, ThinPrep

$16.2M
T1002

RN services, per 15 minutes

$15.5M
99283

Emergency dept visit, moderate complexity

$14.8M