Single-test outliers in Kansas 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
150
warning
166
info
2,142
Total
2,458
MAGED BOTROS (1982651824) bills $507.00/claim for 99283 (Emergency dept visit low mdm) vs avg $40.35 (+14.6Ο). $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.
ASHLEY D FRANCIS, OD, LLC (1720719388) bills $267.53/claim for V2020 (Vision svcs frames purchases) vs avg $37.47 (+13.8Ο). $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.
DOUGLAS COUNTY VISITING NURSES ASSOCIATION, INC. (1831396944): 38.4 claims/beneficiary (avg 2.2). 1,459 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.
KICKAPOO TRIBE IN KANSAS (1992806012) bills $296.44/claim for D0120 (Periodic oral evaluation) vs avg $25.15 (+10.9Ο). $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.
THE CHILDREN'S MERCY HOSPITAL (1154400232) bills $64.85/claim for 81003 (Urinalysis auto w/o scope) vs avg $1.49 (+10.8Ο). $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 HOSPITAL (1154400232) bills $149.33/claim for 71046 (X-ray exam chest 2 views) vs avg $10.12 (+10.7Ο). $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.
HOSPICE CARE OF KANSAS, LLC (1609924638): 28.7 claims/beneficiary (avg 2.2). 31,237 claims, 1,090 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.
NEWMAN MEMORIAL COUNTY HOSPITAL (1114085594) bills $96.19/claim for 93010 (Electrocardiogram report) vs avg $6.38 (+9.1Ο). $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.
SOUTHERNCARE, INC. (1295773273): 27.9 claims/beneficiary (avg 2.2). 17,372 claims, 623 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.
KICKAPOO TRIBE IN KANSAS (1992806012) bills $97.90/claim for 99173 (Visual acuity screen) vs avg $6.08 (+9.0Ο). $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.
HOSPICE CARE OF KANSAS, LLC (1790833382): 27.4 claims/beneficiary (avg 2.2). 162,566 claims, 5,933 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.
ODYSSEY HEALTHCARE OF KANSAS CITY, LLC (1467782516): 26.5 claims/beneficiary (avg 2.2). 11,829 claims, 446 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.
KICKAPOO TRIBE IN KANSAS (1992806012) bills $387.65/claim for D1120 (Prophylaxis - child) vs avg $42.74 (+8.3Ο). $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.
FUTURES UNLIMITED, INC. (1104861525) bills $52.51/claim for 92508 (Tx sp lang voice comm group) vs avg $19.44 (+8.1Ο). $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.
RIVERCROSS HOSPICE L.L.C. (1013157825): 25.1 claims/beneficiary (avg 2.2). 66,320 claims, 2,640 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.
SOUTHERNCARE, INC. (1063459535): 25.0 claims/beneficiary (avg 2.2). 17,241 claims, 689 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.
BETHESDA LUTHERAN COMMUNITIES (1265587356): 25.0 claims/beneficiary (avg 2.2). 149,579 claims, 5,991 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.
HOSPICE CARE OF KANSAS, LLC (1326196627): 24.4 claims/beneficiary (avg 2.2). 562 claims, 23 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.
HOSPICE OF THE PRAIRIE, INC. (1861454118): 23.2 claims/beneficiary (avg 2.2). 4,957 claims, 214 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.
KC CHILDRENS SURGERY CENTER LLC (1124522495) bills $314.53/claim for D0150 (Comprehensive oral evaluation) vs avg $41.85 (+7.4Ο). $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.
KANSAS CITY HOSPICE, INC (1235460361): 22.8 claims/beneficiary (avg 2.2). 11,444 claims, 503 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.
MOORE ENTERPRISES (1053392746): 21.7 claims/beneficiary (avg 2.2). 41,551 claims, 1,918 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.
ADULT SERVICES INC. (1467417881): 21.6 claims/beneficiary (avg 2.2). 269,803 claims, 12,469 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.
MINIMALLY INVASIVE SURGERY HOSPITAL (1619069275) bills $501.91/claim for 88305 (Tissue exam by pathologist) vs avg $46.78 (+6.8Ο). $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.
SOUTHEAST KANSAS INDEPENDENT LIVING RESOURCE CENTER, INC. (1992855852): 21.5 claims/beneficiary (avg 2.2). 8,931 claims, 415 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.
MICHAEL HAUSMANN (1497958227) bills $16.32/claim for 92015 (Determine refractive state) vs avg $5.05 (+6.8Ο). $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.
HEARTLAND MEDICAL CLINIC, INC (1356941306) bills $294.98/claim for 90837 (Psytx w pt 60 minutes) vs avg $89.58 (+6.7Ο). $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.
KVC HOSPITALS INC (1184764151): 21.0 claims/beneficiary (avg 2.2). 19,857 claims, 947 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.
NEIGHBORHOOD NETWORK INC. (1497217376): 20.8 claims/beneficiary (avg 2.2). 720,374 claims, 34,594 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.
JOO WON KASER (1629090097) bills $15.89/claim for 92015 (Determine refractive state) vs avg $5.05 (+6.5Ο). $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.
MAXIM HEALTHCARE SERVICES, INC. (1477788032): 20.6 claims/beneficiary (avg 2.2). 51,189 claims, 2,490 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.
SHERIDAN COUNTY HOSPITAL (1942316799) bills $379.78/claim for 90834 (Psytx w pt 45 minutes) vs avg $63.18 (+6.5Ο). $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.
CARESTAF, INC. (1750359899): 20.5 claims/beneficiary (avg 2.2). 31,415 claims, 1,535 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.
HEALTHCORE CLINIC INC (1033218565) bills $66.07/claim for 96127 (Brief emotional/behav assmt) vs avg $4.06 (+6.4Ο). $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.
HEARTLAND HOSPICE SERVICES LLC (1164475836): 20.3 claims/beneficiary (avg 2.2). 10,482 claims, 516 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. (1275862237): 20.0 claims/beneficiary (avg 2.2). 45,554 claims, 2,274 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.
MAXIM HEALTHCARE SERVICES, INC. (1285742593): 20.0 claims/beneficiary (avg 2.2). 127,912 claims, 6,393 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.
BEST CHOICE HOME HEALTH (1063559938): 20.0 claims/beneficiary (avg 2.2). 212,705 claims, 10,634 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.
COMPASSIONATE CARE HOME HEALTH AGENCY (1528360047): 19.7 claims/beneficiary (avg 2.2). 2,458 claims, 125 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.
KC CHILDRENS SURGERY CENTER LLC (1124522495) bills $1,396.12/claim for D0603 (Caries risk assessment - high risk) vs avg $35.80 (+6.2Ο). $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.
FIRST CHOICE CHILDREN'S HOMECARE, LP (1205371721): 19.6 claims/beneficiary (avg 2.2). 119,451 claims, 6,090 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.
FIRST CARE CLINIC, INC. (1568634327) bills $62.68/claim for D0272 (Bitewings - two radiographic images) vs avg $18.39 (+6.1Ο). $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.
SOUTH WEST PEDIATRICS & ADOLESCENT MEDICINE PA (1548408396) bills $124.38/claim for 90677 (Pcv20 vaccine im) vs avg $5.62 (+6.1Ο). $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.
PRAIRIE BAND POTAWATOMI NATION (1245266410) bills $446.44/claim for 99213 (Office o/p est low 20 min) vs avg $60.31 (+6.1Ο). $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.
MERCY HOME CARE LLC (1326193400): 19.3 claims/beneficiary (avg 2.2). 93,007 claims, 4,816 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.
NEWMAN MEMORIAL COUNTY HOSPITAL (1821306218): 19.3 claims/beneficiary (avg 2.2). 14,606 claims, 758 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 RAPHAEL DIRECT CARE, INC. (1053466110): 19.1 claims/beneficiary (avg 2.2). 129,771 claims, 6,804 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.
KONZA PRAIRIE COMMUNITY HEALTH CENTER, INC. (1447247663) bills $98.93/claim for D1208 (Topical fluoride excluding varnish) vs avg $18.41 (+5.9Ο). $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.
HEARTLAND MEDICAL CLINIC, INC (1356941306) bills $279.24/claim for 90847 (Family psytx w/pt 50 min) vs avg $55.63 (+5.9Ο). $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.
MIRACLE HOME CARE LLC (1124345871): 18.6 claims/beneficiary (avg 2.2). 103,861 claims, 5,575 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.