Single-test outliers in Nevada 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
171
warning
294
info
4,236
Total
4,701
ACCESSIBLE SPACE INC. (1588259972): 52.5 claims/beneficiary (avg 2.4). 48,267 claims, 920 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.
NEVADA HABILITATION CENTER (1033703806): 48.0 claims/beneficiary (avg 2.4). 4,657 claims, 97 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.
OVER THE RAINBOW CARE LLC (1902333115) bills $56.09/claim for 94760 (Measure blood oxygen level) vs avg $1.60 (+14.9Ο). $11,554 across 206 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.
SOLACE CARE LLC (1841877826) bills $1,771.02/claim for Q5001 (Hospice or home hlth in home) vs avg $13.66 (+14.2Ο). $106,261 across 60 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.
HEARTS OF PASSION HOME CARE LLC (1497236541): 37.0 claims/beneficiary (avg 2.4). 16,079 claims, 434 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.
STATE OF NEVADA - NNCAS PSYCH (1649400417) bills $1,008.74/claim for 90792 (Psych diag eval w/med srvcs) vs avg $82.28 (+12.1Ο). $84,734 across 84 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.
RICHARD COTTIERO (1295733988) bills $50.24/claim for 85018 (Hemoglobin) vs avg $1.76 (+11.5Ο). $12,510 across 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.
OLIVE CREST (1851068779): 34.1 claims/beneficiary (avg 2.4). 3,917 claims, 115 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.
RED ROCK HOME HEALTH CARE CORPORATION (1588321251): 33.2 claims/beneficiary (avg 2.4). 7,409 claims, 223 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.
STATE OF NEVADA - NNCAS PSYCH (1649400417) bills $268.38/claim for 90833 (Psytx w pt w e/m 30 min) vs avg $35.20 (+11.0Ο). $88,833 across 331 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.
FRANCISCO PERAZA MD PC (1699962431) bills $7.57/claim for 90723 (Dtap-hep b-ipv vaccine im) vs avg $0.07 (+10.9Ο). $12,571 across 1,660 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.
WILLIAM HOLM (1558556530) bills $65.55/claim for 96110 (Developmental screen w/score) vs avg $6.44 (+10.4Ο). $71,386 across 1,089 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.
AARON OSGA (1275897332) bills $235.16/claim for D2392 (Resin composite - two surfaces posterior) vs avg $44.57 (+10.3Ο). $36,450 across 155 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.
MARK LEWIS (1205863941) bills $127.72/claim for D0150 (Comprehensive oral evaluation) vs avg $25.75 (+10.2Ο). $74,845 across 586 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.
AARON OSGA (1275897332) bills $167.88/claim for D2391 (Resin composite - one surface posterior) vs avg $34.56 (+9.6Ο). $21,321 across 127 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.
STATE OF NEVADA (1740370006) bills $347.58/claim for 99214 (Office o/p est mod 30 min) vs avg $65.49 (+9.5Ο). $115,745 across 333 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.
EMPHASIS HOME SERVICES (1649957333): 27.9 claims/beneficiary (avg 2.4). 2,542 claims, 91 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.
KOINONIA FOSTER HOMES, INC. (1336353101): 26.3 claims/beneficiary (avg 2.4). 16,513 claims, 628 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.
CPD SOUTH MEADOWS LLC (1891441762) bills $145.55/claim for D7140 (Extraction erupted tooth or exposed root) vs avg $35.98 (+8.4Ο). $47,302 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.
CHRISTOPHER CRUZ (1295792182) bills $73.71/claim for 80305 (Drug test prsmv dir opt obs) vs avg $5.89 (+8.4Ο). $44,153 across 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.
SHONNA CURRY (1114907250) bills $67.73/claim for D9230 (Inhalation of nitrous oxide/analgesia) vs avg $14.79 (+8.4Ο). $59,060 across 872 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.
APPLE GROVE TREATMENT CENTER (1215501416): 24.6 claims/beneficiary (avg 2.4). 5,136 claims, 209 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.
SECOND CHANCE RESOURCES LLC (1437683232) bills $968.96/claim for H0004 (Behavioral health counseling and therapy, per 15 minutes) vs avg $128.86 (+7.8Ο). $17,441 across 18 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.
HUMBOLDT GENERAL HOSPITAL (1750498010) bills $267.22/claim for 70450 (Ct head/brain w/o dye) vs avg $51.30 (+7.7Ο). $321,727 across 1,204 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.
TOTAL RENAL CARE INC (1578836086): 23.5 claims/beneficiary (avg 2.4). 5,584 claims, 238 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.
STARS DENTAL (1275714875) bills $25.27/claim for D0230 (Intraoral - periapical each addl image) vs avg $5.76 (+7.5Ο). $72,152 across 2,855 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.
FAMILY HEALTH CARE SERVICES, INC (1346228350) bills $95.96/claim for G0300 (Hhs/hospice of lpn ea 15 min) vs avg $2.32 (+7.5Ο). $380,099 across 3,961 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.
CHERISH HEALTHCARE (1760879894) bills $118.75/claim for G0151 (Hhcp-serv of pt,ea 15 min) vs avg $3.78 (+7.4Ο). $14,250 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.
DARYL CHRISTOPHER (1497350664) bills $1,658.97/claim for H2014 (Skills train and dev, 15 min) vs avg $92.96 (+7.3Ο). $374,926 across 226 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.
CARSON TAHOE REGIONAL HEALTHCARE (1730739129) bills $70.64/claim for 71046 (X-ray exam chest 2 views) vs avg $12.30 (+7.3Ο). $41,609 across 589 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.
STATE OF NEVADA (1740370006) bills $84.40/claim for Q3014 (Telehealth facility fee) vs avg $17.55 (+7.3Ο). $43,552 across 516 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.
DARYL CHRISTOPHER (1497350664) bills $914.74/claim for H0004 (Behavioral health counseling and therapy, per 15 minutes) vs avg $128.86 (+7.3Ο). $208,560 across 228 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.
GENTLE TOUCH BEHAVIORAL HEALTH LLC (1346764081) bills $886.13/claim for H0004 (Behavioral health counseling and therapy, per 15 minutes) vs avg $128.86 (+7.1Ο). $4,946,379 across 5,582 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.
BRETTON DIALYSIS LLC (1033622337): 21.6 claims/beneficiary (avg 2.4). 12,509 claims, 578 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.
FOUR HEARTS HEALTHCARE SOLUTIONS LLC (1821666934): 21.2 claims/beneficiary (avg 2.4). 4,447 claims, 210 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. (1477908762): 21.1 claims/beneficiary (avg 2.4). 12,981 claims, 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.
MEDTRANS (1871915892) bills $630.40/claim for H0047 (Alcohol/drug abuse svc nos) vs avg $71.86 (+6.7Ο). $1,700,195 across 2,697 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.
HAND UP HOMES FOR YOUTH (1679639132) bills $1,109.77/claim for S9480 (Intensive outpatient psychia) vs avg $159.74 (+6.6Ο). $737,997 across 665 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.
DESERT VIEW HOME HEALTH INC (1902090699) bills $100.25/claim for G0152 (Hhcp-serv of ot,ea 15 min) vs avg $3.25 (+6.5Ο). $61,050 across 609 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.
SOUTHERN HILLS MEDICAL CENTER, LLC (1457306359) bills $822.75/claim for 43239 (Egd biopsy single/multiple) vs avg $132.79 (+6.5Ο). $71,579 across 87 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.
BAMBOO SUNRISE LLC (1982281846): 20.3 claims/beneficiary (avg 2.4). 85,433 claims, 4,200 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.
ASSURANCE PROFESSIONAL MANAGEMENT SERVICES INC. (1932767944) bills $1,224.82/claim for T1016 (Case management) vs avg $97.38 (+6.5Ο). $90,637 across 74 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. (1770500746): 20.1 claims/beneficiary (avg 2.4). 178,266 claims, 8,847 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.
COUNTY OF NIAGARA (1841340569) bills $105.17/claim for 99212 (Office o/p est sf 10 min) vs avg $26.84 (+6.4Ο). $13,146 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.
PERSPECTIVE HOME HEALTH INC (1932107281) bills $174.63/claim for G0299 (Hhs/hospice of rn ea 15 min) vs avg $7.35 (+6.3Ο). $1,034,307 across 5,923 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.
STATE OF NEVADA - SNCAS OUTPATIENT (1568539914) bills $253.79/claim for 90847 (Family psytx w/pt 50 min) vs avg $81.70 (+6.2Ο). $1,493,304 across 5,884 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.
DESERT VIEW HOME HEALTH INC (1902090699) bills $79.82/claim for G0300 (Hhs/hospice of lpn ea 15 min) vs avg $2.32 (+6.2Ο). $68,250 across 855 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.
LMS FRESHSTART LLC (1093249484) bills $1,222.56/claim for H0034 (Med trng & support per 15min) vs avg $129.68 (+6.2Ο). $24,451 across 20 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.
HORIZON ACADEMY LLC (1679703805): 19.4 claims/beneficiary (avg 2.4). 19,077 claims, 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.
TRI STATE DENTAL (1578153276) bills $21.81/claim for D0230 (Intraoral - periapical each addl image) vs avg $5.76 (+6.2Ο). $43,891 across 2,012 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.