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

Starlight Home Care Agency INC

Home Health·Saddle Brook, NJ·NPI: 1033370317SharePrint 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:

Cost Outlier

Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.

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

Risk Assessment

Bills $400.11 per claim for T1003 (LPN/LVN services, per 15 minutes) — 16.5× the national median of $24.24.

Bills $449.01 per claim for T1002 (RN services, per 15 minutes) — 12.0× the national median of $37.42.

Bills $469.18 per claim for S9123 (Nursing care, in the home, by RN, per 15 minutes) — 3.8× the national median of $124.86.

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

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $207.3M is at the 50th percentile among 322 Home Health providers.

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

Total Paid

$207.3M

$207,324,062

Total Claims

492K

Beneficiaries

30K

16.6 claims/patient

Avg Cost/Claim

$421

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

🔍 Analysis

Provider Overview

Starlight Home Care Agency INC is a Home Health provider based in Saddle Brook, NJ. From the 2018–2024 period, this provider received $207.3M in Medicaid payments across 492K claims.

Why This Matters

This provider received $207.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,915 Medicaid beneficiaries for a full year at average per-enrollee costs.

8% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$27.3M
+4%
2019
$28.4M
-3%
2020
$27.5M
+1%
2021
$27.9M
+12%
2022
$31.3M
+13%
2023
$35.4M
-17%
2024
$29.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 5 distinct procedure codes. The top code (T1003 (LPN/LVN services, per 15 minutes)) accounts for 44% of total spending.

T1003Top 25%

LPN/LVN services, per 15 minutes

$91.8M

230K claims · 44.3%

Your Cost: $400.11/claim|Median: $24.24
16.5× median
T1002Top 5%

RN services, per 15 minutes

$51.3M

114K claims · 24.8%

Your Cost: $449.01/claim|Median: $37.42
12.0× median
S9124Normal range

Nursing care, in the home; per hour

$42.1M

101K claims · 20.3%

Your Cost: $415.54/claim|Median: $400.25
1.0× median
S9123Top 25%

Nursing care, in the home, by RN, per 15 minutes

$19.1M

41K claims · 9.2%

Your Cost: $469.18/claim|Median: $124.86
3.8× median
T1000Normal range

Private duty/independent nursing service(s)

$3.0M

7K claims · 1.4%

Your Cost: $450.72/claim|Median: $402.76
1.1× median