Statistical Outliers

Single-test outliers in Kansas Medicaid data. These are individual statistical flags — 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 — 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

106

warning

210

info

2,142

Total

2,458

Outliers by Type

Severity Distribution

critical

106 (4.3%)

warning

210 (8.5%)

info

2,142 (87.1%)

1,860 results

criticalCost OutlierScore: 14.6

Cost-per-claim above average for 99283 (Emergency Dept Visit (Moderate Complexity))

MAGED BOTROS (1982651824) bills $507.00/claim for 99283 (Emergency dept visit low mdm) vs avg $40.35 (+14.6σ). $12,675 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.

MAGED BOTROSWICHITAProvider total: $12.7K

criticalCost OutlierScore: 13.8

Cost-per-claim above average for V2020

ASHLEY D FRANCIS, OD, LLC (1720719388) bills $267.53/claim for V2020 (Vision svcs frames purchases) vs avg $37.47 (+13.8σ). $26,485 across 99 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.

ASHLEY D FRANCIS, OD, LLCLAWRENCEProvider total: $33.7K

criticalCost OutlierScore: 10.9

Cost-per-claim above average for D0120 (Periodic Oral Evaluation (Established Patient))

KICKAPOO TRIBE IN KANSAS (1992806012) bills $296.44/claim for D0120 (Periodic oral evaluation) vs avg $25.15 (+10.9σ). $24,308 across 82 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.

KICKAPOO TRIBE IN KANSASHORTONProvider total: $1.0M

criticalCost OutlierScore: 10.8

Cost-per-claim above average for 81003 (Urinalysis by Dipstick (Automated))

THE CHILDREN'S MERCY HOSPITAL (1154400232) bills $64.85/claim for 81003 (Urinalysis auto w/o scope) vs avg $1.49 (+10.8σ). $22,633 across 349 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 CHILDREN'S MERCY HOSPITALOVERLAND PARKProvider total: $22.3M

criticalCost OutlierScore: 10.7

Cost-per-claim above average for 71046 (Chest X-ray (2 views, Frontal and Lateral))

THE CHILDREN'S MERCY HOSPITAL (1154400232) bills $149.33/claim for 71046 (X-ray exam chest 2 views) vs avg $10.12 (+10.7σ). $139,920 across 937 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 CHILDREN'S MERCY HOSPITALOVERLAND PARKProvider total: $22.3M

criticalCost OutlierScore: 9.1

Cost-per-claim above average for 93010

NEWMAN MEMORIAL COUNTY HOSPITAL (1114085594) bills $96.19/claim for 93010 (Electrocardiogram report) vs avg $6.38 (+9.1σ). $64,546 across 671 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.

NEWMAN MEMORIAL COUNTY HOSPITALEMPORIAProvider total: $7.0M

criticalCost OutlierScore: 9.0

Cost-per-claim above average for 99173

KICKAPOO TRIBE IN KANSAS (1992806012) bills $97.90/claim for 99173 (Visual acuity screen) vs avg $6.08 (+9.0σ). $10,280 across 105 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.

KICKAPOO TRIBE IN KANSASHORTONProvider total: $1.0M

criticalCost OutlierScore: 8.3

Cost-per-claim above average for D1120 (Child Dental Prophylaxis (Teeth Cleaning))

KICKAPOO TRIBE IN KANSAS (1992806012) bills $387.65/claim for D1120 (Prophylaxis - child) vs avg $42.74 (+8.3σ). $22,096 across 57 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.

KICKAPOO TRIBE IN KANSASHORTONProvider total: $1.0M

criticalCost OutlierScore: 8.1

Cost-per-claim above average for 92508 (Speech-Language Therapy (Group))

FUTURES UNLIMITED, INC. (1104861525) bills $52.51/claim for 92508 (Tx sp lang voice comm group) vs avg $19.44 (+8.1σ). $69,264 across 1,319 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.

FUTURES UNLIMITED, INC.WELLINGTONProvider total: $16.5M

criticalCost OutlierScore: 7.4

Cost-per-claim above average for D0150 (Comprehensive Oral Evaluation (New or Established Patient))

KC CHILDRENS SURGERY CENTER LLC (1124522495) bills $314.53/claim for D0150 (Comprehensive oral evaluation) vs avg $41.85 (+7.4σ). $844,209 across 2,684 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.

KC CHILDRENS SURGERY CENTER LLCKANSAS CITYProvider total: $13.8M

criticalCost OutlierScore: 6.8

Cost-per-claim above average for 88305

MINIMALLY INVASIVE SURGERY HOSPITAL (1619069275) bills $501.91/claim for 88305 (Tissue exam by pathologist) vs avg $46.78 (+6.8σ). $37,643 across 75 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.

MINIMALLY INVASIVE SURGERY HOSPITALLENEXAProvider total: $1.1M

criticalCost OutlierScore: 6.8

Cost-per-claim above average for 92015

MICHAEL HAUSMANN (1497958227) bills $16.32/claim for 92015 (Determine refractive state) vs avg $5.05 (+6.8σ). $14,411 across 883 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.

MICHAEL HAUSMANNGARDEN CITYProvider total: $113.2K

criticalCost OutlierScore: 6.7

Cost-per-claim above average for 90837 (Psychotherapy (60 min))

HEARTLAND MEDICAL CLINIC, INC (1356941306) bills $294.98/claim for 90837 (Psytx w pt 60 minutes) vs avg $89.58 (+6.7σ). $193,804 across 657 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.

HEARTLAND MEDICAL CLINIC, INCLAWRENCEProvider total: $11.4M

criticalCost OutlierScore: 6.5

Cost-per-claim above average for 92015

JOO WON KASER (1629090097) bills $15.89/claim for 92015 (Determine refractive state) vs avg $5.05 (+6.5σ). $11,072 across 697 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.

JOO WON KASEROVERLAND PARKProvider total: $53.0K

criticalCost OutlierScore: 6.5

Cost-per-claim above average for 90834 (Psychotherapy (45 min))

SHERIDAN COUNTY HOSPITAL (1942316799) bills $379.78/claim for 90834 (Psytx w pt 45 minutes) vs avg $63.18 (+6.5σ). $29,243 across 77 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.

SHERIDAN COUNTY HOSPITALHOXIEProvider total: $898.7K

criticalCost OutlierScore: 6.4

Cost-per-claim above average for 96127 (Brief Emotional/Behavioral Assessment)

HEALTHCORE CLINIC INC (1033218565) bills $66.07/claim for 96127 (Brief emotional/behav assmt) vs avg $4.06 (+6.4σ). $91,249 across 1,381 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.

HEALTHCORE CLINIC INCWICHITAProvider total: $15.3M

criticalCost OutlierScore: 6.2

Cost-per-claim above average for D0603

KC CHILDRENS SURGERY CENTER LLC (1124522495) bills $1,396.12/claim for D0603 (Caries risk assessment - high risk) vs avg $35.80 (+6.2σ). $92,144 across 66 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.

KC CHILDRENS SURGERY CENTER LLCKANSAS CITYProvider total: $13.8M

criticalCost OutlierScore: 6.1

Cost-per-claim above average for D0272 (Dental X-rays (Bitewings, 2 Films))

FIRST CARE CLINIC, INC. (1568634327) bills $62.68/claim for D0272 (Bitewings - two radiographic images) vs avg $18.39 (+6.1σ). $36,294 across 579 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.

FIRST CARE CLINIC, INC.HAYSProvider total: $4.1M

criticalCost OutlierScore: 6.1

Cost-per-claim above average for 90677

SOUTH WEST PEDIATRICS & ADOLESCENT MEDICINE PA (1548408396) bills $124.38/claim for 90677 (Pcv20 vaccine im) vs avg $5.62 (+6.1σ). $13,309 across 107 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 WEST PEDIATRICS & ADOLESCENT MEDICINE PALIBERALProvider total: $833.4K

criticalCost OutlierScore: 6.1

Cost-per-claim above average for 99213 (Office Visit, Established Patient (20 min, Low Complexity))

PRAIRIE BAND POTAWATOMI NATION (1245266410) bills $446.44/claim for 99213 (Office o/p est low 20 min) vs avg $60.31 (+6.1σ). $2,716,149 across 6,084 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.

PRAIRIE BAND POTAWATOMI NATIONMAYETTAProvider total: $2.7M

criticalCost OutlierScore: 5.9

Cost-per-claim above average for D1208

KONZA PRAIRIE COMMUNITY HEALTH CENTER, INC. (1447247663) bills $98.93/claim for D1208 (Topical fluoride excluding varnish) vs avg $18.41 (+5.9σ). $77,658 across 785 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.

KONZA PRAIRIE COMMUNITY HEALTH CENTER, INC.JUNCTION CITYProvider total: $11.5M

criticalCost OutlierScore: 5.9

Cost-per-claim above average for 90847 (Family Psychotherapy with Patient (50 min))

HEARTLAND MEDICAL CLINIC, INC (1356941306) bills $279.24/claim for 90847 (Family psytx w/pt 50 min) vs avg $55.63 (+5.9σ). $27,645 across 99 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.

HEARTLAND MEDICAL CLINIC, INCLAWRENCEProvider total: $11.4M

criticalCost OutlierScore: 5.8

Cost-per-claim above average for 92014

PRAIRIESTAR HEALTH CENTER, INC (1871564534) bills $161.12/claim for 92014 (Compre oph exam est pt 1/>) vs avg $56.22 (+5.8σ). $110,847 across 688 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.

PRAIRIESTAR HEALTH CENTER, INCHUTCHINSONProvider total: $13.9M

criticalCost OutlierScore: 5.8

Cost-per-claim above average for D0230 (Dental X-ray (Periapical, Each Additional))

CHERYL BIESTERFELD (1992761134) bills $37.03/claim for D0230 (Intraoral - periapical each addl image) vs avg $7.71 (+5.8σ). $36,032 across 973 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.

CHERYL BIESTERFELDLAWRENCEProvider total: $438.2K

criticalCost OutlierScore: 5.8

Cost-per-claim above average for 90837 (Psychotherapy (60 min))

HEART OF KANSAS FAMILY HEALTH CARE, INC. (1992220990) bills $267.23/claim for 90837 (Psytx w pt 60 minutes) vs avg $89.58 (+5.8σ). $12,292 across 46 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.

HEART OF KANSAS FAMILY HEALTH CARE, INC.LARNEDProvider total: $779.4K

criticalCost OutlierScore: 5.5

Cost-per-claim above average for D0230 (Dental X-ray (Periapical, Each Additional))

DOUGLAS COUNTY DENTAL CLINIC, INC (1396734737) bills $35.68/claim for D0230 (Intraoral - periapical each addl image) vs avg $7.71 (+5.5σ). $38,285 across 1,073 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.

DOUGLAS COUNTY DENTAL CLINIC, INCLAWRENCEProvider total: $466.4K

criticalCost OutlierScore: 5.5

Cost-per-claim above average for D1208

1669657029 (1669657029) bills $94.23/claim for D1208 (Topical fluoride excluding varnish) vs avg $18.41 (+5.5σ). $92,535 across 982 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.

1669657029Provider total: $372.0K

criticalCost OutlierScore: 5.5

Cost-per-claim above average for D0274 (Dental X-rays (Bitewings, 4 Films))

FIRST CARE CLINIC, INC. (1568634327) bills $80.31/claim for D0274 (Bitewings - four radiographic images) vs avg $26.78 (+5.5σ). $185,270 across 2,307 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.

FIRST CARE CLINIC, INC.HAYSProvider total: $4.1M

criticalCost OutlierScore: 5.5

Cost-per-claim above average for 90837 (Psychotherapy (60 min))

UNITED METHODIST WESTERN KANSAS MEXICAN-AMERICAN MINISTRIES, INC. (1871789719) bills $257.41/claim for 90837 (Psytx w pt 60 minutes) vs avg $89.58 (+5.5σ). $52,769 across 205 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.

UNITED METHODIST WESTERN KANSAS MEXICAN-AMERICAN MINISTRIES, INC.LIBERALProvider total: $299.3K

criticalCost OutlierScore: 5.2

Cost-per-claim above average for 96110

COFFEYVILLE REGIONAL MEDICAL CENTER INC (1053862805) bills $88.76/claim for 96110 (Developmental screen w/score) vs avg $24.71 (+5.2σ). $143,527 across 1,617 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.

COFFEYVILLE REGIONAL MEDICAL CENTER INCCOFFEYVILLEProvider total: $2.5M

criticalCost OutlierScore: 5.2

Cost-per-claim above average for 90723

SAMAH MURAD (1295932424) bills $27.90/claim for 90723 (Dtap-hep b-ipv vaccine im) vs avg $1.11 (+5.2σ). $12,473 across 447 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.

SAMAH MURADOLATHEProvider total: $616.2K

criticalCost OutlierScore: 5.2

Cost-per-claim above average for D0120 (Periodic Oral Evaluation (Established Patient))

1215220884 (1215220884) bills $153.31/claim for D0120 (Periodic oral evaluation) vs avg $25.15 (+5.2σ). $12,725 across 83 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.

1215220884Provider total: $51.3K

criticalCost OutlierScore: 5.2

Cost-per-claim above average for D0272 (Dental X-rays (Bitewings, 2 Films))

SALINA HEALTH EDUCATION FOUNDATION (1396836029) bills $55.69/claim for D0272 (Bitewings - two radiographic images) vs avg $18.39 (+5.2σ). $83,533 across 1,500 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.

SALINA HEALTH EDUCATION FOUNDATIONSALINAProvider total: $8.7M

criticalCost OutlierScore: 5.2

Cost-per-claim above average for T2025

KANSAS COMMUNITY HOME HEALTHCARE LLC (1720593973) bills $434.63/claim for T2025 (Waiver service, nos) vs avg $102.80 (+5.2σ). $1,796,777 across 4,134 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.

KANSAS COMMUNITY HOME HEALTHCARE LLCKANSAS CITYProvider total: $19.6M

criticalCost OutlierScore: 5.1

Cost-per-claim above average for D0120 (Periodic Oral Evaluation (Established Patient))

SALINA HEALTH EDUCATION FOUNDATION (1477871580) bills $151.09/claim for D0120 (Periodic oral evaluation) vs avg $25.15 (+5.1σ). $297,352 across 1,968 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.

SALINA HEALTH EDUCATION FOUNDATIONSALINAProvider total: $1.1M

criticalCost OutlierScore: 5.0

Cost-per-claim above average for 99307 (Subsequent Nursing Facility Care (Straightforward))

GEARY COUNTY HOSPITAL (1699877555) bills $113.18/claim for 99307 (Sbsq nf care sf mdm 10) vs avg $10.75 (+5.0σ). $33,276 across 294 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.

GEARY COUNTY HOSPITALJUNCTION CITYProvider total: $5.5M

criticalCost OutlierScore: 5.0

Cost-per-claim above average for J3490

PINNACLE REGIONAL HOSPITAL, INC. (1952629370) bills $29.14/claim for J3490 (Drugs unclassified injection) vs avg $2.29 (+5.0σ). $17,981 across 617 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.

PINNACLE REGIONAL HOSPITAL, INC.OVERLAND PARKProvider total: $12.8M

criticalCost OutlierScore: 4.9

Cost-per-claim above average for D1208

HEARTLAND MEDICAL CLINIC, INC. (1487107447) bills $85.51/claim for D1208 (Topical fluoride excluding varnish) vs avg $18.41 (+4.9σ). $1,400,270 across 16,375 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.

HEARTLAND MEDICAL CLINIC, INC.LAWRENCEProvider total: $8.0M

criticalCost OutlierScore: 4.9

Cost-per-claim above average for D7140 (Tooth Extraction (Erupted Tooth, Simple))

KC CHILDRENS SURGERY CENTER LLC (1124522495) bills $193.07/claim for D7140 (Extraction erupted tooth or exposed root) vs avg $78.01 (+4.9σ). $773,637 across 4,007 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.

KC CHILDRENS SURGERY CENTER LLCKANSAS CITYProvider total: $13.8M

criticalCost OutlierScore: 4.8

Cost-per-claim above average for A0425 (Ground Ambulance Mileage (per mile))

STAGECOACH TRANSPORTATION L.L.C. (1760987945) bills $279.21/claim for A0425 (Ground mileage) vs avg $50.79 (+4.9σ). $30,433 across 109 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.

STAGECOACH TRANSPORTATION L.L.C.DODGE CITYProvider total: $236.8K

criticalCost OutlierScore: 4.8

Cost-per-claim above average for T2003

KINGDOM TRANSPORTATION LLC (1649813494) bills $177.69/claim for T2003 (N-et; encounter/trip) vs avg $31.88 (+4.8σ). $807,066 across 4,542 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.

KINGDOM TRANSPORTATION LLCOLATHEProvider total: $1.2M

criticalCost OutlierScore: 4.8

Cost-per-claim above average for 90834 (Psychotherapy (45 min))

HEARTLAND MEDICAL CLINIC, INC (1356941306) bills $297.58/claim for 90834 (Psytx w pt 45 minutes) vs avg $63.18 (+4.8σ). $91,059 across 306 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.

HEARTLAND MEDICAL CLINIC, INCLAWRENCEProvider total: $11.4M

criticalCost OutlierScore: 4.8

Cost-per-claim above average for 81002 (Urinalysis without Microscopy)

GENIE PIERSON (1508124694) bills $17.63/claim for 81002 (Urinalysis nonauto w/o scope) vs avg $2.27 (+4.8σ). $18,701 across 1,061 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.

GENIE PIERSONKANSAS CITYProvider total: $235.6K

criticalCost OutlierScore: 4.8

Cost-per-claim above average for D0120 (Periodic Oral Evaluation (Established Patient))

HEALTH PARTNERSHIP CLINIC, INC. (1265785232) bills $143.43/claim for D0120 (Periodic oral evaluation) vs avg $25.15 (+4.8σ). $198,507 across 1,384 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.

HEALTH PARTNERSHIP CLINIC, INC.OLATHEProvider total: $2.4M

criticalCost OutlierScore: 4.7

Cost-per-claim above average for S5125

STAR LIVING LLC (1316464373) bills $8,024.53/claim for S5125 (Attendant care service /15m) vs avg $1,299.51 (+4.7σ). $842,576 across 105 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.

STAR LIVING LLCLAWRENCEProvider total: $842.6K

criticalCost OutlierScore: 4.7

Cost-per-claim above average for 90723

TERESA CROWE (1083741425) bills $25.24/claim for 90723 (Dtap-hep b-ipv vaccine im) vs avg $1.11 (+4.7σ). $23,144 across 917 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.

TERESA CROWETOPEKAProvider total: $618.5K

criticalCost OutlierScore: 4.7

Cost-per-claim above average for D0274 (Dental X-rays (Bitewings, 4 Films))

HEALTHCORE CLINIC INC (1033218565) bills $71.73/claim for D0274 (Bitewings - four radiographic images) vs avg $26.78 (+4.6σ). $79,618 across 1,110 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.

HEALTHCORE CLINIC INCWICHITAProvider total: $15.3M

criticalCost OutlierScore: 4.6

Cost-per-claim above average for 90837 (Psychotherapy (60 min))

UNITED METHODIST WESTERN KANSAS MEXICAN-AMERICAN MINISTRIES, INC. (1730174228) bills $231.99/claim for 90837 (Psytx w pt 60 minutes) vs avg $89.58 (+4.6σ). $212,732 across 917 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.

UNITED METHODIST WESTERN KANSAS MEXICAN-AMERICAN MINISTRIES, INC.GARDEN CITYProvider total: $2.5M

criticalCost OutlierScore: 4.6

Cost-per-claim above average for D0120 (Periodic Oral Evaluation (Established Patient))

NADER RASTGOFTAR (1669858288) bills $140.18/claim for D0120 (Periodic oral evaluation) vs avg $25.15 (+4.6σ). $42,475 across 303 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.

NADER RASTGOFTAROLATHEProvider total: $186.4K

criticalCost OutlierScore: 4.6

Cost-per-claim above average for 97530 (Therapeutic Activities (per 15 min))

ST. NICHOLAS CHILDREN'S THERAPIES LLC (1285626937) bills $123.43/claim for 97530 (Therapeutic activities) vs avg $24.23 (+4.6σ). $35,548 across 288 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. NICHOLAS CHILDREN'S THERAPIES LLCROELAND PARKProvider total: $35.5K

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