Single-test outliers in Alaska Medicaid data. These are individual statistical flags β most are informational.
Important context: These findings identify statistically unusual billing patterns, not determinations of wrongdoing. Cost-per-claim comparisons may flag hospital outpatient departments whose reimbursements include facility fees, bundled services, or all-inclusive rates. High claims-per-beneficiary ratios may reflect legitimate care patterns at behavioral health facilities, pediatric specialty centers, or residential care programs. Additional investigation and clinical context are required before drawing any conclusions.
For provider level analytics using multiple independent tests, see the Watchlist β which flags providers only when 2+ different detection methods agree. These single-test outliers below are primarily informational; only Cost Outliers and Overutilization are flagged as critical/warning.
critical
53
warning
213
info
1,572
Total
1,838
BRISTOL BAY AREA HEALTH CORPORATION (1770782831) bills $392.44/claim for D0274 (Bitewings - four radiographic images) vs avg $49.42 (+9.1Ο). $736,614 across 1,877 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
YUKON-KUSKOKWIM HEALTH CORPORATION (1063567691) bills $496.24/claim for 36415 (Coll venous bld venipuncture) vs avg $13.15 (+8.9Ο). $5,607,054 across 11,299 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
YUKON KUSKOKWIM HEALTH CORP (1659583383) bills $862.00/claim for 99203 (Office o/p new low 30 min) vs avg $122.15 (+8.8Ο). $10,344 across 12 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
PROVIDENCE HEALTH & SERVICES WASHINGTON (1053363119) bills $244.41/claim for D0230 (Intraoral - periapical each addl image) vs avg $18.17 (+8.3Ο). $64,281 across 263 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
MANIILAQ ASSOCIATION (1316995210) bills $339.31/claim for 92015 (Determine refractive state) vs avg $31.18 (+8.3Ο). $806,883 across 2,378 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
TANANA CHIEFS CONFERENCE (1821201278) bills $669.55/claim for 92340 (Fit spectacles monofocal) vs avg $53.46 (+7.8Ο). $5,472,265 across 8,173 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTH EAST ALASKA REGIONAL HEALTH CONSORTIUM (1699811612) bills $545.61/claim for D1206 (Topical fluoride varnish) vs avg $45.86 (+6.8Ο). $2,127,874 across 3,900 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS (1730322785) bills $440.52/claim for 83036 (Hemoglobin glycosylated a1c) vs avg $29.22 (+6.3Ο). $18,061 across 41 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
FRONTIER PARTNERS, LLC (1285356204): 39.8 claims/beneficiary (avg 3.7). 16,622 claims, 418 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
BRISTOL BAY AREA HEALTH CORPORATION (1770782831) bills $516.70/claim for D0272 (Bitewings - two radiographic images) vs avg $57.35 (+5.6Ο). $1,071,630 across 2,074 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
THE SALVATION ARMY OLDER ALASKANS PROGRAM (1386867315): 37.8 claims/beneficiary (avg 3.7). 11,127 claims, 294 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
ST LAWRENCE ASSISTED LIVING INC (1265619837): 35.1 claims/beneficiary (avg 3.7). 10,298 claims, 293 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
METLAKATLA INDIAN COMMUNITY (1740294081) bills $347.69/claim for D9230 (Inhalation of nitrous oxide/analgesia) vs avg $58.69 (+5.0Ο). $39,984 across 115 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
DELTA MEDICAL TRANSPORT LLC (1396026944) bills $176.01/claim for A0425 (Ground mileage) vs avg $12.83 (+4.9Ο). $141,161 across 802 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTH EAST ALASKA REGIONAL HEALTH CONSORTIUM (1114973849) bills $945.18/claim for 99214 (Office o/p est mod 30 min) vs avg $165.18 (+4.9Ο). $15,123 across 16 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTHEAST ALASKA REGIONAL HEALTH CONSTORTIUM (1881374650) bills $728.46/claim for 97530 (Therapeutic activities) vs avg $132.35 (+4.8Ο). $653,430 across 897 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
MANIILAQ ASSOCIATION (1699392258) bills $763.73/claim for T1023 (Program intake assessment) vs avg $89.54 (+4.8Ο). $220,718 across 289 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
CHUGACHMIUT (1316147069) bills $611.42/claim for D1120 (Prophylaxis - child) vs avg $89.75 (+4.7Ο). $157,136 across 257 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTHCENTRAL FOUNDATION (1720603095) bills $577.14/claim for 97112 (Neuromuscular reeducation) vs avg $87.59 (+4.6Ο). $24,240 across 42 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM (1811693039) bills $903.45/claim for 99214 (Office o/p est mod 30 min) vs avg $165.18 (+4.6Ο). $15,359 across 17 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTH EAST ALASKA REGIONAL HEALTH CONSORTIUM (1881730802) bills $380.33/claim for D1206 (Topical fluoride varnish) vs avg $45.86 (+4.5Ο). $6,171,547 across 16,227 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
KETCHIKAN INDIAN CORPORATION (1821120486) bills $779.77/claim for 80305 (Drug test prsmv dir opt obs) vs avg $60.77 (+4.5Ο). $67,840 across 87 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTHCENTRAL FOUNDATION (1669057279) bills $542.73/claim for D0150 (Comprehensive oral evaluation) vs avg $95.83 (+4.4Ο). $17,910 across 33 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
NORTON SOUND HEALTH CORPORATION (1225101041) bills $125.58/claim for 87340 (Hepatitis b surface ag ia) vs avg $13.09 (+4.2Ο). $124,075 across 988 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTHCENTRAL FOUNDATION (1174027296) bills $842.64/claim for 99214 (Office o/p est mod 30 min) vs avg $165.18 (+4.2Ο). $425,531 across 505 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
BRISTOL BAY AREA HEALTH CORPORATION (1831270842) bills $684.18/claim for 80307 (Drug test prsmv chem anlyzr) vs avg $93.21 (+4.2Ο). $142,994 across 209 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
CHUGACHMIUT (1316147069) bills $565.50/claim for D0220 (Intraoral - periapical first image) vs avg $67.83 (+4.2Ο). $28,840 across 51 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM (1417671967) bills $1,000.88/claim for H0033 (Oral med adm direct observe) vs avg $117.80 (+4.2Ο). $251,220 across 251 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
NORTON SOUND HEALTH CORP (1891818522) bills $510.10/claim for D0150 (Comprehensive oral evaluation) vs avg $95.83 (+4.1Ο). $707,510 across 1,387 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
NORTON SOUND HEALTH CORP (1295856391) bills $943.65/claim for 99213 (Office o/p est low 20 min) vs avg $163.24 (+4.1Ο). $48,126 across 51 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
BRISTOL BAY AREA HEALTH CORPORATION (1831270842) bills $439.80/claim for 81003 (Urinalysis auto w/o scope) vs avg $42.89 (+4.0Ο). $57,175 across 130 claims.
This provider charges significantly more (or less) per claim for a specific procedure code compared to peers in the same state. This can indicate upcoding, incorrect billing, or specialty services.
FRONTIER ASSISTED LIVING LLC (1457880064): 33.4 claims/beneficiary (avg 3.7). 6,071 claims, 182 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
LIVING STONE HOME CARE, LLC (1952587552): 33.2 claims/beneficiary (avg 3.7). 5,446 claims, 164 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
PRIMROSE SENIOR HOLDINGS, LLC (1467696641): 33.2 claims/beneficiary (avg 3.7). 830 claims, 25 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
PROVIDENCE HEALTH & SERVICES-WASHINGTON (1952323859): 33.0 claims/beneficiary (avg 3.7). 89,858 claims, 2,721 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
HARBOR VIEW MANOR (1700103173): 32.7 claims/beneficiary (avg 3.7). 4,315 claims, 132 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
PETERSBURG BOROUGH (1023132784): 32.7 claims/beneficiary (avg 3.7). 9,503 claims, 291 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
QUEEN OF HEARTS ASSISTED LIVING HOME LLC (1689086241): 32.4 claims/beneficiary (avg 3.7). 3,689 claims, 114 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
SAINT TIMOTHY HOME LLC (1386983419): 32.1 claims/beneficiary (avg 3.7). 5,545 claims, 173 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
DIVISION OF ALASKAN PIONEER HOMES (1497873087): 31.7 claims/beneficiary (avg 3.7). 42,694 claims, 1,348 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
ASPEN CREEK KENAI LLC (1689335291): 31.4 claims/beneficiary (avg 3.7). 41,108 claims, 1,310 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
DIVISION OF ALASKAN PIONEER HOMES (1477671063): 31.3 claims/beneficiary (avg 3.7). 54,328 claims, 1,735 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
FORAYS (1881354132): 31.3 claims/beneficiary (avg 3.7). 15,065 claims, 481 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
DIVISION OF ALASKAN PIONEER HOMES (1740308337): 31.2 claims/beneficiary (avg 3.7). 39,086 claims, 1,251 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
LAKE VIEW HOME I, II, & III (1821114588): 31.0 claims/beneficiary (avg 3.7). 46,367 claims, 1,495 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
DIVISION OF ALASKAN PIONEER HOMES (1285752873): 31.0 claims/beneficiary (avg 3.7). 35,232 claims, 1,138 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
SPRINGCREEK DOWLING LLC (1770134942): 30.8 claims/beneficiary (avg 3.7). 33,171 claims, 1,076 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
FRONTIER HOME HEALTH CARE (1619242872): 30.7 claims/beneficiary (avg 3.7). 32,529 claims, 1,058 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
LOVING HOME CARE, LLC (1871967836): 30.6 claims/beneficiary (avg 3.7). 33,085 claims, 1,080 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.
HOMER SENIOR CITIZENS, INC. (1982828224): 30.5 claims/beneficiary (avg 3.7). 7,386 claims, 242 beneficiaries.
The ratio of claims to unique patients is unusually high, suggesting each patient receives many more services than average. May indicate overutilization or inappropriate repeat billing.