Single-test outliers in Delaware 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
58
warning
101
info
791
Total
950
HELP AT HOME OF DELAWARE, LLC (1336868686): 34.1 claims/beneficiary (avg 2.9). 100,244 claims, 2,943 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.
TOBOLA HEALTH CARE SERVICES INC. (1861853012): 31.9 claims/beneficiary (avg 2.9). 8,731 claims, 274 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.
THE NEMOURS FOUNDATION (1467505073) bills $194.06/claim for A0425 (Ground mileage) vs avg $10.51 (+6.6Ο). $570,737 across 2,941 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.
EPIC HEALTH SERVICES (DE), LLC (1487834768): 29.9 claims/beneficiary (avg 2.9). 278,890 claims, 9,330 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.
BEEBE PHYSICIAN NETWORK INC. (1730133992) bills $77.28/claim for 99211 (Off/op est may x req phy/qhp) vs avg $11.45 (+6.3Ο). $234,620 across 3,036 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.
MAXIM HEALTHCARE SERVICES, INC. (1356421077): 29.7 claims/beneficiary (avg 2.9). 23,012 claims, 776 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.
KATHERYN GOLDMAN (1629579735) bills $8.86/claim for D0603 (Caries risk assessment - high risk) vs avg $0.22 (+6.2Ο). $10,460 across 1,181 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.
ABOVE EXPECTATIONS LLC (1477170165): 28.6 claims/beneficiary (avg 2.9). 11,957 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.
NEIGHBORLY HOME CARE (1548760689): 28.0 claims/beneficiary (avg 2.9). 180,508 claims, 6,454 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.
INTEGRATED HEALTH ASSOCIATES LLC (1306284856): 27.9 claims/beneficiary (avg 2.9). 58,245 claims, 2,090 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.
ACSR, INC. (1629112255): 27.8 claims/beneficiary (avg 2.9). 15,871 claims, 570 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.
AT HOME INFUCARE, LLC (1649521022): 27.5 claims/beneficiary (avg 2.9). 233,682 claims, 8,510 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.
CARING ANGELS HOMECARE AGENCY, INC. (1124598156): 27.3 claims/beneficiary (avg 2.9). 176,927 claims, 6,482 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.
PRN STAFFERS INC (1417563107): 26.2 claims/beneficiary (avg 2.9). 52,010 claims, 1,985 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.
ELITE HOME HEALTH CARE INC (1821512278): 26.2 claims/beneficiary (avg 2.9). 104,429 claims, 3,991 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.
CONEXIO CARE, INC. (1073181848): 25.8 claims/beneficiary (avg 2.9). 65,679 claims, 2,541 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.
STEPS CENTER LLC (1932614393): 25.7 claims/beneficiary (avg 2.9). 19,016 claims, 741 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.
ALWAYS BEST CARE OF DELAWARE (1801332861): 25.5 claims/beneficiary (avg 2.9). 403,415 claims, 15,818 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.
FIRST STATE RESIDENTIAL LIVING LLC (1790344901): 25.4 claims/beneficiary (avg 2.9). 305 claims, 12 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.
ADDUS HEALTHCARE INC (1366408932): 25.4 claims/beneficiary (avg 2.9). 23,271 claims, 916 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.
NEWARK EMERGENCY CENTER (1700864576) bills $135.93/claim for 99213 (Office o/p est low 20 min) vs avg $33.48 (+5.2Ο). $1,954,342 across 14,378 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.
EPIC HEALTH SERVICES (DE), LLC (1164752697): 24.8 claims/beneficiary (avg 2.9). 135,353 claims, 5,447 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.
THE NEMOURS FOUNDATION (1467505073) bills $40.59/claim for 90471 (Immunization admin) vs avg $5.80 (+5.2Ο). $74,241 across 1,829 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.
AMAZING HOME CARE AGENCY (1942859327): 24.4 claims/beneficiary (avg 2.9). 103,927 claims, 4,252 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.
PACKD LLC (1649803792): 24.4 claims/beneficiary (avg 2.9). 232,568 claims, 9,517 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.
LIBERTY DIALYSIS - WILMINGTON LLC (1821284662) bills $1.37/claim for A4657 (Syringe w/wo needle) vs avg $0.13 (+4.3Ο). $26,318 across 19,155 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.
SINGSON MEDICAL GROUP PA (1457437832) bills $50.51/claim for G0439 (Ppps, subseq visit) vs avg $6.39 (+4.2Ο). $34,450 across 682 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.
INPATIENT CONSULTANTS OF MARYLAND, P.C. (1922487859) bills $61.99/claim for 99308 (Sbsq nf care low mdm 20) vs avg $11.56 (+4.2Ο). $29,567 across 477 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.
UHS OF ROCKFORD LLC (1942273552) bills $159.71/claim for 90853 (Group psychotherapy) vs avg $18.15 (+4.1Ο). $237,008 across 1,484 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.
VAMAN PATEL (1831610534) bills $113.38/claim for 97530 (Therapeutic activities) vs avg $21.76 (+4.1Ο). $48,751 across 430 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.
BAYHEALTH MEDICAL CENTER, INC. (1023006434) bills $190.68/claim for J1756 (Iron sucrose injection) vs avg $16.32 (+4.1Ο). $30,699 across 161 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.
SMILEY PEDIATRIC SPEECH THERAPY LLC (1639870520) bills $111.90/claim for 97530 (Therapeutic activities) vs avg $21.76 (+4.0Ο). $102,498 across 916 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.
CARE AT HOME OF DELAWARE, LLC (1023665874): 23.7 claims/beneficiary (avg 2.9). 138,304 claims, 5,837 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.
MAXIM HEALTHCARE SERVICES, INC. (1124101456): 23.6 claims/beneficiary (avg 2.9). 50,005 claims, 2,119 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.
CARITAS HOME HEALTH SERVICES, INC (1083981294): 23.3 claims/beneficiary (avg 2.9). 27,724 claims, 1,189 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.
PSYCHOTHERAPEUTIC SERVICES INC (1790145209): 22.1 claims/beneficiary (avg 2.9). 8,583 claims, 388 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.
AMERICARE HOME SOLUTIONS (1457799561): 21.7 claims/beneficiary (avg 2.9). 81,717 claims, 3,771 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.
DELAWARE ADULT DAYCARE LLC (1730662933): 21.4 claims/beneficiary (avg 2.9). 15,142 claims, 706 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.
BAYADA HOME HEALTH CARE, INC. (1962947705): 21.2 claims/beneficiary (avg 2.9). 166,852 claims, 7,887 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.
INCREDIBLE HOME CARE INC (1326609744): 21.2 claims/beneficiary (avg 2.9). 11,411 claims, 539 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.
BAYADA HOME HEALTH CARE, INC. (1821029422): 20.1 claims/beneficiary (avg 2.9). 268,381 claims, 13,368 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.
RRW INC. (1376845909): 19.8 claims/beneficiary (avg 2.9). 98,454 claims, 4,970 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.
RESOURCES FOR HUMAN DEVELOPMENT INC. (1083743678): 19.7 claims/beneficiary (avg 2.9). 123,360 claims, 6,272 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.
BAYHEALTH MEDICAL CENTER, INC. (1467546135) bills $7.10/claim for 82565 (Assay of creatinine) vs avg $0.68 (+4.0Ο). $10,026 across 1,412 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.
RADNON HOME CARE LLC (1528538543): 19.6 claims/beneficiary (avg 2.9). 39,736 claims, 2,028 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.
THE NEMOURS FOUNDATION (1437553633) bills $262.14/claim for A0429 (Bls-emergency) vs avg $47.00 (+3.9Ο). $22,020 across 84 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.
GUNNING PARTNERS, LLC (1154829620): 19.5 claims/beneficiary (avg 2.9). 39,742 claims, 2,039 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.
BEEBE MEDICAL CENTER, INC. (1821196486) bills $78.85/claim for 99212 (Office o/p est sf 10 min) vs avg $21.94 (+3.8Ο). $13,405 across 170 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.
GAUDENZIA INC (1073768123): 18.3 claims/beneficiary (avg 2.9). 5,420 claims, 296 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.
ABUNDANT LIFE COMMUNITY DEVELOPMENT CORPORATION (1568810430): 18.3 claims/beneficiary (avg 2.9). 19,247 claims, 1,052 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.