Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Tridia Hospice Care, LLC

Hospice Care, Community Based·Westerville, OH·NPI: 1013181205SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Single-Code

Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Extreme procedure concentration — 89% of all billing flows through just 2 codes (T2046, T2042).

This is a statistical summary, not an accusation. See our methodology.

Compared to Hospice Care, Community Based Peers

Total spending distribution among 8 providers in this specialty

P25MedianP75P90

This provider's total spending of $138.8M is at the 50th percentile among 8 Hospice Care, Community Based providers.

Active Billing Period:2018-012024-11(83 months)

Extreme procedure concentration — 89% of $138.8M billed through just 2 codes

Total Paid

$138.8M

$138,840,949

Total Claims

799K

Beneficiaries

30K

27.0 claims/patient

Avg Cost/Claim

$174

#801 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Tridia Hospice Care, LLC is a Hospice Care, Community Based provider based in Westerville, OH. From the 2018–2024 period, this provider received $138.8M in Medicaid payments across 799K claims.

Why This Matters

This provider received $138.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 17,355 Medicaid beneficiaries for a full year at average per-enrollee costs.

251% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$8.7M
+66%
2019
$14.5M
+21%
2020
$17.5M
+23%
2021
$21.5M
+15%
2022
$24.8M
-15%
2023
$21.1M
+46%
2024
$30.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 2 distinct procedure codes. The top code (T2046 (Habilitation, residential, waiver; per month)) accounts for 89% of total spending.

T2046Normal range

Habilitation, residential, waiver; per month

$122.9M

693K claims · 88.5%

Your Cost: $177.26/claim|Median: $1,795.74
0.1× median
T2042Normal range

Financial management, self-directed, waiver, per month

$15.9M

105K claims · 11.5%

Your Cost: $150.88/claim|Median: $188.03
0.8× median

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