Single-test outliers in Indiana 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
283
warning
393
info
6,903
Total
7,579
MUNSTER MEDICAL RESEARCH FOUNDATION INC (1003918210) bills $391.29/claim for 99232 (Sbsq hosp ip/obs moderate 35) vs avg $27.97 (+13.4Ο). $143,212 across 366 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.
REID HOSPITAL & HEALTH CARE SERVICES, INC (1063457380) bills $582.33/claim for 99222 (1st hosp ip/obs moderate 55) vs avg $53.58 (+12.8Ο). $62,892 across 108 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.
DEACONESS HOSPITAL, INC. (1053361642) bills $11.80/claim for J1100 (Dexamethasone sodium phos) vs avg $0.39 (+11.3Ο). $36,108 across 3,059 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.
OMNIA HEALTH CARE LLC (1316640972): 40.8 claims/beneficiary (avg 2.4). 3,140 claims, 77 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.
INDIANA UNIVERSITY HEALTH JAY, INC. (1801315692) bills $61.51/claim for 90471 (Immunization admin) vs avg $8.86 (+10.8Ο). $133,178 across 2,165 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.
ST MARY MEDICAL CENTER INC (1558463745) bills $321.46/claim for 99232 (Sbsq hosp ip/obs moderate 35) vs avg $27.97 (+10.8Ο). $10,608 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.
HERITAGE ADULT DAY INC (1003122334) bills $382.78/claim for T2003 (N-et; encounter/trip) vs avg $19.06 (+10.5Ο). $546,233 across 1,427 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.
PARKVIEW HOSPITAL, INC. (1366407603) bills $88.16/claim for 96110 (Developmental screen w/score) vs avg $6.97 (+10.5Ο). $11,019 across 125 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.
ST. VINCENT HOSPITAL & HEALTH CARE CENTER, INC. (1306898960) bills $26.33/claim for 99173 (Visual acuity screen) vs avg $1.45 (+10.4Ο). $358,967 across 13,631 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.
PARKVIEW HOSPITAL, INC. (1366407603) bills $389.62/claim for 99211 (Off/op est may x req phy/qhp) vs avg $21.77 (+10.4Ο). $1,968,374 across 5,052 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.
SENIOR SUPPORT SERVICES INC (1700164563): 37.9 claims/beneficiary (avg 2.4). 4,316 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.
MISBAH HOME CARE AGENCY LLC (1619543642): 37.8 claims/beneficiary (avg 2.4). 66,508 claims, 1,760 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.
VPA PC (1720605884) bills $295.55/claim for 99203 (Office o/p new low 30 min) vs avg $53.15 (+10.1Ο). $618,583 across 2,093 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.
ST CATHERINE HOSPITAL INC (1689776882) bills $300.44/claim for 99232 (Sbsq hosp ip/obs moderate 35) vs avg $27.97 (+10.0Ο). $514,059 across 1,711 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.
DEACONESS HOSPITAL, INC. (1053361642) bills $122.92/claim for 94640 (Airway inhalation treatment) vs avg $11.46 (+9.7Ο). $276,453 across 2,249 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.
VPA PC (1720605884) bills $260.28/claim for 99213 (Office o/p est low 20 min) vs avg $40.62 (+9.6Ο). $88,757 across 341 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.
JOHN JACOBS (1568454163) bills $312.75/claim for 99202 (Office o/p new sf 15 min) vs avg $38.72 (+9.4Ο). $45,661 across 146 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.
BRIAN HERR (1700888575) bills $103.89/claim for G0299 (Hhs/hospice of rn ea 15 min) vs avg $1.57 (+9.3Ο). $255,160 across 2,456 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.
HUGO SENIOR HOUSING, LLC (1114308616): 33.8 claims/beneficiary (avg 2.4). 2,837 claims, 84 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.
MEMORIAL HOSPITAL (1356320469) bills $106.08/claim for 96127 (Brief emotional/behav assmt) vs avg $4.53 (+8.9Ο). $28,960 across 273 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.
VPA PC (1255958310) bills $297.82/claim for 99202 (Office o/p new sf 15 min) vs avg $38.72 (+8.8Ο). $192,692 across 647 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.
ST. VINCENT HOSPITAL & HEALTH CARE CENTER, INC. (1306898960) bills $109.00/claim for 92551 (Pure tone hearing test air) vs avg $6.53 (+8.8Ο). $428,807 across 3,934 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.
RESCARE INC. (1649487745): 32.6 claims/beneficiary (avg 2.4). 21,622 claims, 663 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.
DAMAR CHARTER SCHOOL INC (1194098525) bills $326.85/claim for 92507 (Tx sp lang voice comm indiv) vs avg $54.51 (+8.8Ο). $11,113 across 34 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.
INDIANA EXCEPTIONAL MEDICAL CARE (1669708756) bills $49.20/claim for G0439 (Ppps, subseq visit) vs avg $0.82 (+8.6Ο). $45,458 across 924 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.
INDIANA UNIVERSITY HEALTH INC (1114958584) bills $578.68/claim for 99231 (Sbsq hosp ip/obs sf/low 25) vs avg $25.33 (+8.4Ο). $372,090 across 643 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.
INDIANA UNIVERSITY HEALTH NORTH HOSPITAL INC (1568492916) bills $575.87/claim for 99231 (Sbsq hosp ip/obs sf/low 25) vs avg $25.33 (+8.4Ο). $14,397 across 25 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.
SHAS, INC (1982961744): 30.3 claims/beneficiary (avg 2.4). 14,222 claims, 469 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.
TJF INVESTMENT GROUP INC D/B/A D-BEST HOME CARE (1366823148): 29.9 claims/beneficiary (avg 2.4). 1,138 claims, 38 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 HEALTH CARE AGENCY, LLC (1851658223): 29.9 claims/beneficiary (avg 2.4). 59,261 claims, 1,982 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.
BLESSED HANDS HOME CARE AGENCY LLC (1174952188): 29.7 claims/beneficiary (avg 2.4). 4,336 claims, 146 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.
CHILDREN'S THERAPY INNOVATIONS INC. (1407166192): 29.7 claims/beneficiary (avg 2.4). 190,048 claims, 6,402 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.
HARRISON COUNTY HOSPITAL (1851378137) bills $17.00/claim for 83690 (Assay of lipase) vs avg $3.41 (+7.9Ο). $31,802 across 1,871 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.
HAMILTON CENTER INC. (1265053854): 29.6 claims/beneficiary (avg 2.4). 57,963 claims, 1,960 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.
FAITHFUL FRIENDS HOME HEALTHCARE (1912930447): 29.6 claims/beneficiary (avg 2.4). 81,359 claims, 2,753 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.
NOBLE HOME HEALTH CARE LLC (1912278904): 29.5 claims/beneficiary (avg 2.4). 27,455 claims, 932 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.
CAREGIVER HOMES OF SOUTH DAKOTA INC (1023588043): 29.4 claims/beneficiary (avg 2.4). 253,482 claims, 8,616 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 PTIORITY HEALTHCARE SERVICES INC (1366940785): 28.9 claims/beneficiary (avg 2.4). 45,313 claims, 1,569 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.
TODD'S COMPANIONPLUS OF IN LLC (1447464177) bills $4,566.15/claim for S5125 (Attendant care service /15m) vs avg $272.44 (+7.7Ο). $529,673 across 116 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.
CANNAN HEALTHCARE SERVICES & STAFFING INC (1902227002): 28.8 claims/beneficiary (avg 2.4). 23,436 claims, 815 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.
ALLEGIANCE HOME HEALTH AGENCY INC (1811594807): 28.5 claims/beneficiary (avg 2.4). 1,764 claims, 62 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.
MERIDIAN HEALTH SERVICES CORP (1346748654) bills $289.43/claim for T1015 (Clinic service) vs avg $21.52 (+7.6Ο). $3,022,484 across 10,443 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.
VPA PC (1255958310) bills $324.06/claim for 99204 (Office o/p new mod 45 min) vs avg $78.79 (+7.5Ο). $103,374 across 319 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.
1891799763 (1891799763) bills $99.54/claim for D0140 (Limited oral evaluation - problem focused) vs avg $30.26 (+7.4Ο). $44,294 across 445 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.
GIBSON GENERAL HOSPITAL INC. (1558346007) bills $506.75/claim for 99231 (Sbsq hosp ip/obs sf/low 25) vs avg $25.33 (+7.3Ο). $10,642 across 21 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.
CJ'S HOMECARE INC. (1417900085): 27.5 claims/beneficiary (avg 2.4). 97,634 claims, 3,555 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.
1326447939 (1326447939) bills $482.90/claim for 99283 (Emergency dept visit low mdm) vs avg $70.42 (+7.2Ο). $15,453 across 32 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.
KIDS PLAY SENSORY GYM LLC (1922518463): 27.0 claims/beneficiary (avg 2.4). 1,295 claims, 48 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.
FREEDOM HOME CARE, LLC. (1053825703): 26.9 claims/beneficiary (avg 2.4). 81,616 claims, 3,034 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.
COMMUNITY HCA, INC. (1740481894): 26.8 claims/beneficiary (avg 2.4). 230,645 claims, 8,594 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.