Single-test outliers in Louisiana 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
246
warning
554
info
7,253
Total
8,053
OUR LADY OF THE ANGELS HOSPITAL, INC. (1093140600) bills $111.43/claim for 92551 (Pure tone hearing test air) vs avg $4.52 (+18.7Ο). $56,605 across 508 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.
LORI GAUTREAUX (1942576855) bills $17.67/claim for G8427 (Docrev cur meds by elig clin) vs avg $0.07 (+15.8Ο). $11,451 across 648 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.
AA ANGEL CARE INC (1013269570) bills $435.30/claim for T1019 (Personal care ser per 15 min) vs avg $66.14 (+15.6Ο). $206,767 across 475 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.
1326447939 (1326447939) bills $112.22/claim for 80053 (Comprehen metabolic panel) vs avg $5.07 (+14.7Ο). $83,830 across 747 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 ARC OF SABINE INC (1457481376) bills $1,758.07/claim for S5125 (Attendant care service /15m) vs avg $143.86 (+13.1Ο). $7,114,902 across 4,047 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.
1326447939 (1326447939) bills $48.50/claim for 85025 (Complete cbc w/auto diff wbc) vs avg $3.28 (+13.1Ο). $50,436 across 1,040 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.
1326447939 (1326447939) bills $265.79/claim for 87635 (Sars-cov-2 covid-19 amp prb) vs avg $23.50 (+12.0Ο). $121,999 across 459 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.
CONVENIENT CARE LLC (1164422630) bills $89.11/claim for 99211 (Off/op est may x req phy/qhp) vs avg $10.27 (+10.8Ο). $31,366 across 352 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.
PARISH HOSPITAL SERVICE DISTRICT FOR THE PARISH OF ORLEANS - DIST A (1225450588) bills $1,318.26/claim for 20610 (Drain/inj joint/bursa w/o us) vs avg $45.31 (+10.3Ο). $39,548 across 30 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.
CLHG-OAKDALE, LLC (1104873710) bills $50.82/claim for J1885 (Ketorolac tromethamine inj) vs avg $2.01 (+9.9Ο). $61,137 across 1,203 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.
HOMEDICA OF LOUISIANA, LLC (1174866479) bills $123.23/claim for 99490 (Chrnc care mgmt staff 1st 20) vs avg $3.68 (+9.7Ο). $2,185,897 across 17,739 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.
WK TOTS TO TEENS PEDIATRIC CENTER (1063769255) bills $18.61/claim for 96127 (Brief emotional/behav assmt) vs avg $0.75 (+9.7Ο). $54,542 across 2,931 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.
UNIVERSITY HOSPITAL & CLINICS, INC. (1306281126) bills $107.98/claim for 90734 (Menacwyd/menacwycrm vacc im) vs avg $1.38 (+9.4Ο). $14,793 across 137 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.
CATHOLIC CHARITIES (1659572790): 74.1 claims/beneficiary (avg 4.6). 4,815 claims, 65 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.
BIENVILLE MEDICAL CENTER INC (1285835561) bills $100.54/claim for 96372 (Ther/proph/diag inj sc/im) vs avg $5.11 (+9.1Ο). $160,762 across 1,599 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.
G B COOLEY HOSPITAL SERVICES/PCA (1982887022): 72.5 claims/beneficiary (avg 4.6). 163,899 claims, 2,262 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.
MEDCOMP GX, LLC (1508268731) bills $2.86/claim for K1034 (Provision of covid-19 test, nonprescription self-administered and) vs avg $0.05 (+8.8Ο). $13,221 across 4,622 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.
RAFAEL JUSTINIANO MAGRANER (1871925297) bills $127.50/claim for 99232 (Sbsq hosp ip/obs moderate 35) vs avg $22.13 (+8.7Ο). $58,266 across 457 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.
ESSENTIAL TRANSPORTATION LLC (1235813940) bills $283.09/claim for T2003 (N-et; encounter/trip) vs avg $36.19 (+8.7Ο). $73,321 across 259 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.
EVERGREEN PRESBYTERIAN MINISTRIES, INC. (1336288802) bills $1,193.27/claim for S5125 (Attendant care service /15m) vs avg $143.86 (+8.5Ο). $8,265,761 across 6,927 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.
CROSSROADS LA. INC. (1366573115): 68.9 claims/beneficiary (avg 4.6). 194,369 claims, 2,819 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.
CHRISTUS HEALTH CENTRAL LOUISIANA (1205824208) bills $898.73/claim for 96361 (Hydrate iv infusion add-on) vs avg $41.88 (+8.3Ο). $26,962 across 30 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.
HELPING HANDS OF NEW ORLEANS (1689894701): 66.1 claims/beneficiary (avg 4.6). 89,138 claims, 1,349 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.
BRUCE PROFESSIONAL COUNSELING SERVICES, LLC (1477956126) bills $900.00/claim for T2023 (Targeted case mgmt per month) vs avg $168.95 (+8.0Ο). $14,400 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.
JOSHUA KALUZNY (1225652449) bills $108.62/claim for D1351 (Sealant per tooth) vs avg $28.14 (+7.9Ο). $25,092 across 231 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.
EVERGREEN PRESBYTERIAN MINISTRIES, INC. (1326192634) bills $1,111.65/claim for S5125 (Attendant care service /15m) vs avg $143.86 (+7.9Ο). $10,418,374 across 9,372 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 ARC OF SABINE INC (1518097435) bills $312.21/claim for T2002 (N-et; per diem) vs avg $27.45 (+7.8Ο). $24,040 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.
RIVERSIDE MEDICAL CENTER (1700874062) bills $104.12/claim for J0696 (Ceftriaxone sodium injection) vs avg $4.92 (+7.8Ο). $42,794 across 411 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.
SECURE PATIENT DELIVERY LLC (1538515036) bills $256.10/claim for T2003 (N-et; encounter/trip) vs avg $36.19 (+7.8Ο). $2,342,321 across 9,146 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.
LOUISIANA EXPRESS PHARMACY (1326122987) bills $97.54/claim for A4253 (Blood glucose/reagent strips) vs avg $5.85 (+7.8Ο). $67,594 across 693 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.
UPWARD HEALTH OF LOUISIANA LLC (1871144725) bills $289.06/claim for 99499 (Unlisted e&m service) vs avg $14.40 (+7.3Ο). $4,860,624 across 16,815 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.
CDF HEALTHCARE OF LA, LLC (1831402296): 60.2 claims/beneficiary (avg 4.6). 17,925 claims, 298 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 MARTIN HOSPITAL, INC. (1437482817) bills $47.25/claim for J0702 (Betamethasone acet&sod phosp) vs avg $2.42 (+7.3Ο). $10,111 across 214 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.
SOUTHLAKE PEDIATRICS, INC. (1144315250) bills $61.69/claim for 90461 (Im admin each addl component) vs avg $1.44 (+7.2Ο). $39,546 across 641 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.
DARRYL BRUNO (1710072178) bills $10.21/claim for 90785 (Psytx complex interactive) vs avg $1.59 (+7.2Ο). $19,798 across 1,940 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 HOSPITAL SERVICE DISTRICT OF WEST FELICIANA PARISH LOUISIANA (1164497533) bills $80.94/claim for 96372 (Ther/proph/diag inj sc/im) vs avg $5.11 (+7.2Ο). $236,664 across 2,924 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.
VOLUNTEERS OF AMERICA OF NORTH LOUISIANA (1417252230) bills $221.35/claim for H2017 (Psysoc rehab svc, per 15 min) vs avg $57.78 (+7.1Ο). $7,250,982 across 32,758 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.
BATON ROUGE GENERAL MEDICAL CENTER (1962537407) bills $807.16/claim for 17110 (Destruct b9 lesion 1-14) vs avg $68.61 (+7.1Ο). $10,493 across 13 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.
STERLINGTON CRITICAL ACCESS HOSPITAL, L.L.C. (1811171085) bills $39.75/claim for 99307 (Sbsq nf care sf mdm 10) vs avg $3.80 (+7.0Ο). $145,706 across 3,666 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.
NORMAL LIFE OF LAFAYETTE, INC (1356400550): 58.0 claims/beneficiary (avg 4.6). 33,207 claims, 573 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.
ASSOCIATION FOR RETARDED CITIZENS (1588687412) bills $965.63/claim for S5125 (Attendant care service /15m) vs avg $143.86 (+6.7Ο). $24,254,717 across 25,118 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.
MEDCOMP SCIENCES LLC (1982940862) bills $43.44/claim for 87186 (Microbe susceptible mic) vs avg $5.87 (+6.7Ο). $14,118 across 325 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.
JEFFERSON PEDIATRIC CLINIC (1972642197) bills $29.95/claim for 90620 (Menb-4c vacc 2 dose im) vs avg $1.56 (+6.6Ο). $11,769 across 393 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.
RENEX DIALYSIS FACILITIES, INC. (1124130828) bills $62.87/claim for J0887 (Epoetin beta esrd use) vs avg $1.42 (+6.6Ο). $104,615 across 1,664 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.
HAVEN'S GATEWAY PERSONAL CARE FACILITY, INC (1215196811): 54.7 claims/beneficiary (avg 4.6). 32,447 claims, 593 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.
LESLIE BOSTICK (1477575009) bills $12.72/claim for 96127 (Brief emotional/behav assmt) vs avg $0.75 (+6.5Ο). $12,772 across 1,004 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.
KYLE ANDRUS (1316982028) bills $47.55/claim for V2020 (Vision svcs frames purchases) vs avg $16.25 (+6.5Ο). $20,685 across 435 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.
SOUTHLAKE PEDIATRICS, INC. (1144315250) bills $58.37/claim for 90460 (Im admin 1st/only component) vs avg $2.19 (+6.5Ο). $93,333 across 1,599 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.
DELUXE MEDICAL CORPORATION (1255899936) bills $277.27/claim for 87798 (Detect agent nos dna amp) vs avg $34.43 (+6.4Ο). $245,384 across 885 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.
SPECIAL NEEDS UNLIMITED, L.L.C. (1457577892): 53.0 claims/beneficiary (avg 4.6). 162,096 claims, 3,056 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.