Single-test outliers in Nebraska 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
42
warning
128
info
2,036
Total
2,206
RENAL TREATMENT CENTERS-ILLINOIS INC (1225455298): 36.5 claims/beneficiary (avg 2.0). 9,233 claims, 253 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.
FIRSTCARE HOME HEALTH OF EASTERN NEBRASKA, INC (1801898176): 33.9 claims/beneficiary (avg 2.0). 85,901 claims, 2,535 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.
QUALITY LIVING, INC (1891804308): 30.0 claims/beneficiary (avg 2.0). 5,519 claims, 184 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.
HEARTLAND FAMILY SERVICE (1750559332): 25.8 claims/beneficiary (avg 2.0). 12,311 claims, 478 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.
OMAHA TRIBE OF NEBRASKA (1114922143) bills $50.62/claim for 36415 (Coll venous bld venipuncture) vs avg $5.42 (+8.8Ο). $102,602 across 2,027 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 COMMUNITY SUPPORTS NETWORK INC (1134421696): 17.3 claims/beneficiary (avg 2.0). 189,679 claims, 10,983 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.
FRANCISCAN CARE SERVICES INC (1003923079) bills $278.81/claim for 90834 (Psytx w pt 45 minutes) vs avg $98.88 (+7.0Ο). $40,986 across 147 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. (1932202439): 17.0 claims/beneficiary (avg 2.0). 97,646 claims, 5,751 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.
ALCOHOL AND DRUG SOLUTIONS (1679948335): 15.9 claims/beneficiary (avg 2.0). 588 claims, 37 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.
DVA RENAL HEALTHCARE, INC (1962464388): 15.5 claims/beneficiary (avg 2.0). 7,366 claims, 476 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.
FIDELITY HOME HEALTH CARE LLC (1841546926): 15.2 claims/beneficiary (avg 2.0). 1,311 claims, 86 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.
HEARTLAND HEALTH CENTER, INC. (1275954299) bills $222.61/claim for 90832 (Psytx w pt 30 minutes) vs avg $68.35 (+5.9Ο). $70,123 across 315 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.
CRETE FAMILY EYECARE PC (1578310918) bills $140.82/claim for V2100 (Lens spher single plano 4.00) vs avg $27.39 (+5.8Ο). $16,757 across 119 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.
BLUESTEM HEALTH (1184194557) bills $56.06/claim for 99173 (Visual acuity screen) vs avg $4.06 (+5.8Ο). $21,021 across 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.
HOPESPOKE (1578603833): 14.5 claims/beneficiary (avg 2.0). 6,399 claims, 442 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 ACTION PARTNERSHIP OF WESTERN NEBRASKA (1437261211) bills $108.04/claim for 90853 (Group psychotherapy) vs avg $30.11 (+5.7Ο). $16,098 across 149 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.
DVA RENAL HEALTHCARE INC (1699737049): 14.3 claims/beneficiary (avg 2.0). 7,061 claims, 495 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.
RENAL TREATMENT CENTERS-ILLINOIS INC (1760766984): 14.2 claims/beneficiary (avg 2.0). 1,083 claims, 76 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.
STEPHEN CENTER, INC. (1205135001): 13.9 claims/beneficiary (avg 2.0). 15,222 claims, 1,092 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.
BEHAVIORAL HEALTH SPECIALISTS SUNRISE PLACE (1922160969): 13.5 claims/beneficiary (avg 2.0). 19,971 claims, 1,478 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.
BEHAVIORAL HEALTH SPECIALISTS, INC SEEKERS OF SERENITY PLACE (1649334368): 13.4 claims/beneficiary (avg 2.0). 16,953 claims, 1,269 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.
SENIOR VISION SERVICES LLC (1861779266) bills $64.58/claim for V2103 (Spherocylindr 4.00d/12-2.00d) vs avg $22.38 (+5.2Ο). $19,309 across 299 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.
ANTELOPE MEMORIAL HOSPITAL (1083790893) bills $143.32/claim for 87426 (Sarscov coronavirus ag ia) vs avg $29.98 (+5.2Ο). $17,198 across 120 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.
RENAL TREATMENT CENTERS-ILLINOIS INC. (1669826103): 13.1 claims/beneficiary (avg 2.0). 2,788 claims, 213 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 HOSPITAL ASSOCIATION (1841204500) bills $333.97/claim for 0241U vs avg $125.54 (+4.8Ο). $34,733 across 104 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.
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC (1184642894) bills $44.02/claim for J1100 (Dexamethasone sodium phos) vs avg $4.35 (+4.8Ο). $28,043 across 637 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.
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC (1184642894) bills $1,321.92/claim for 74176 (Ct abd & pelvis w/o contrast) vs avg $220.02 (+4.8Ο). $89,890 across 68 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.
NEBRASKA URBAN INDIAN HEALTH COALITION, INC. (1033184866) bills $111.53/claim for 99211 (Off/op est may x req phy/qhp) vs avg $24.66 (+4.6Ο). $70,041 across 628 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.
CHARLES DREW HEALTH CENTER, INC (1629385331) bills $188.53/claim for 90832 (Psytx w pt 30 minutes) vs avg $68.35 (+4.6Ο). $19,230 across 102 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.
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC (1184642894) bills $27.54/claim for 83550 (Iron binding test) vs avg $4.13 (+4.5Ο). $10,216 across 371 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.
CENTRAL DISTRICT HEALTH DEPARTMENT (1700036837) bills $180.64/claim for 90651 (9vhpv vaccine 2/3 dose im) vs avg $23.22 (+4.4Ο). $88,513 across 490 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.
BLUESTEM HEALTH (1184194557) bills $208.49/claim for 99391 (Per pm reeval est pat infant) vs avg $85.89 (+4.3Ο). $153,656 across 737 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'S COMMUNITY HOSPITAL (1528016995) bills $420.81/claim for 87420 (Resp syncytial virus ag ia) vs avg $49.96 (+4.3Ο). $12,203 across 29 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.
REGIONAL WEST GARDEN COUNTY (1144633223) bills $121.96/claim for 87804 (Influenza assay w/optic) vs avg $26.99 (+4.2Ο). $25,611 across 210 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.
RENAL TREATMENT CENTERS-ILLINOIS INC. (1487616819): 12.8 claims/beneficiary (avg 2.0). 15,024 claims, 1,175 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.
RENAL TREATMENT CENTERS-ILLINOIS INC. (1134181563): 12.7 claims/beneficiary (avg 2.0). 5,290 claims, 417 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.
INTELLIRIDE, A DIVISION OF TRANSDEV (1295193795): 12.3 claims/beneficiary (avg 2.0). 49,501 claims, 4,029 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.
RENAL TREATMENT CENTERS-ILLINOIS INC. (1659640522): 11.8 claims/beneficiary (avg 2.0). 16,497 claims, 1,404 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.
RENAL TREATMENT CENTERS-ILLINOIS INC. (1437111853): 11.6 claims/beneficiary (avg 2.0). 15,346 claims, 1,327 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.
DVA RENAL HEALTHCARE INC (1902868367): 11.0 claims/beneficiary (avg 2.0). 11,139 claims, 1,014 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.
RENAL TREATMENT CENTERS ILLINOIS INC (1013294156): 10.9 claims/beneficiary (avg 2.0). 1,321 claims, 121 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.
DIALYSIS CLINIC INC (1528581949): 10.9 claims/beneficiary (avg 2.0). 1,616 claims, 148 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.
DIALYSIS CLINIC INC. (1609809086): 10.8 claims/beneficiary (avg 2.0). 9,324 claims, 861 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.
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC (1073608204) bills $329.71/claim for 99215 (Office o/p est hi 40 min) vs avg $94.46 (+4.0Ο). $100,892 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.
FATHER FLANAGAN'S BOYS HOME (1396269726): 10.6 claims/beneficiary (avg 2.0). 7,424 claims, 702 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.
HEARTLAND HEALTH CENTER, INC (1952953978) bills $220.11/claim for 99213 (Office o/p est low 20 min) vs avg $57.76 (+3.9Ο). $546,978 across 2,485 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.
AMBER IDE DDS, LLC (1750950937) bills $45.72/claim for D0120 (Periodic oral evaluation) vs avg $21.89 (+3.9Ο). $34,659 across 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.
BUTLER COUNTY HEALTH CARE CENTER (1790780237) bills $140.48/claim for 97530 (Therapeutic activities) vs avg $28.79 (+3.9Ο). $62,512 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.
HEARTLAND HEALTH CENTER, INC (1699305896) bills $217.93/claim for 99213 (Office o/p est low 20 min) vs avg $57.76 (+3.9Ο). $88,481 across 406 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.
DOUG STREIFEL LLC (1710249172) bills $103.09/claim for V2203 (Lens sphcyl bifocal 4.00d/.1) vs avg $42.79 (+3.9Ο). $11,547 across 112 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.