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

Yukon-kuskokwim Health Corporation

General Acute Care Hospital Rural·Bethel, AK·NPI: 1063567691SharePrint Report
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Red Flags Explained

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

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Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

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

Risk Assessment

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Bills $169.60 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity) — 4.5× the national median of $37.81.

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Bills $485.84 per claim for 87070 (Bacterial culture, any source except blood or urine) — 82.5× the national median of $5.89.

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Bills $479.14 per claim for 80053 (Comprehensive metabolic panel) — 66.2× the national median of $7.24.

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Billing in the top 1% nationally for 26 procedure codes: 99213, 87070, 80053.

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

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$205.3M

$205,264,788

Total Claims

1.2M

Beneficiaries

901K

1.3 claims/patient

Avg Cost/Claim

$170

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

🔍 Analysis

Provider Overview

Yukon-kuskokwim Health Corporation is a General Acute Care Hospital Rural provider based in Bethel, AK. From the 2018–2024 period, this provider received $205.3M in Medicaid payments across 1.2M claims.

Why This Matters

This provider received $205.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,658 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 48% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$25.6M
+3%
2019
$26.3M
-20%
2020
$21.1M
+21%
2021
$25.6M
+34%
2022
$34.3M
+0%
2023
$34.3M
+11%
2024
$38.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 8% of total spending.

99213Top 1%

Office/outpatient visit, est. patient, low-mod complexity

$16.9M

100K claims · 8.3%

Your Cost: $169.60/claim|Median: $37.81
4.5× median
87070Top 1%

Bacterial culture, any source except blood or urine

$16.4M

34K claims · 8.0%

Your Cost: $485.84/claim|Median: $5.89
82.5× median
80053Top 1%

Comprehensive metabolic panel

$15.6M

33K claims · 7.6%

Your Cost: $479.14/claim|Median: $7.24
66.2× median
99283Top 25%

Emergency dept visit, moderate complexity

$11.6M

93K claims · 5.6%

Your Cost: $124.60/claim|Median: $42.48
2.9× median
87491Top 1%

Chlamydia detection, nucleic acid, amplified probe

$10.2M

39K claims · 5.0%

Your Cost: $262.66/claim|Median: $24.95
10.5× median
90471Top 1%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$10.0M

27K claims · 4.9%

Your Cost: $366.85/claim|Median: $9.80
37.4× median
81001Top 1%

Urinalysis, automated, with microscopy

$9.3M

31K claims · 4.5%

Your Cost: $304.44/claim|Median: $2.03
150.0× median
99282Top 5%

Emergency dept visit, low complexity

$8.3M

35K claims · 4.0%

Your Cost: $235.51/claim|Median: $37.72
6.2× median
97110Top 1%

Therapeutic exercises, each 15 min

$5.9M

9K claims · 2.9%

Your Cost: $632.57/claim|Median: $24.49
25.8× median
36415Top 1%

Collection of venous blood by venipuncture

$5.6M

11K claims · 2.7%

Your Cost: $496.24/claim|Median: $1.57
316.1× median
99214Top 25%

Office/outpatient visit, est. patient, mod-high complexity

$5.4M

62K claims · 2.6%

Your Cost: $86.02/claim|Median: $53.41
1.6× median
71046Top 1%

Chest X-ray, 2 views

$4.7M

33K claims · 2.3%

Your Cost: $145.08/claim|Median: $8.92
16.3× median
87086Top 1%

Urine culture, colony count, with identification

$4.5M

25K claims · 2.2%

Your Cost: $177.41/claim|Median: $5.31
33.4× median
80076Top 1%

Hepatic function panel

$4.2M

7K claims · 2.0%

Your Cost: $562.68/claim|Median: $4.59
122.6× median
87880Top 1%

Streptococcus, Group A, rapid antigen detection

$3.8M

8K claims · 1.8%

Your Cost: $484.71/claim|Median: $11.48
42.2× median
86580Top 1%

Tuberculosis (TB) skin test

$3.7M

7K claims · 1.8%

Your Cost: $567.33/claim|Median: $4.46
127.2× median
99442Top 1%

Telephone E/M by physician, 11-20 minutes

$3.6M

5K claims · 1.8%

Your Cost: $663.37/claim|Median: $22.44
29.6× median
99443Top 1%

Telephone E/M by physician, 21-30 min

$2.7M

4K claims · 1.3%

Your Cost: $661.13/claim|Median: $32.55
20.3× median
80048Top 1%

Basic metabolic panel

$2.7M

7K claims · 1.3%

Your Cost: $403.89/claim|Median: $5.78
69.9× median
80307Top 1%

Drug test, presumptive, by chemistry analyzers

$2.2M

8K claims · 1.1%

Your Cost: $267.05/claim|Median: $35.43
7.5× median
80061Top 1%

Lipid panel

$2.1M

12K claims · 1.0%

Your Cost: $178.18/claim|Median: $8.41
21.2× median
86480Top 1%

Tuberculosis test, cell-mediated immunity

$2.1M

8K claims · 1.0%

Your Cost: $260.06/claim|Median: $38.35
6.8× median
99212Top 5%

Office/outpatient visit, low complexity

$2.0M

10K claims · 1.0%

Your Cost: $201.41/claim|Median: $25.06
8.0× median
96374Top 1%

Therapeutic/prophylactic/diagnostic IV push, single substance

$1.6M

6K claims · 0.8%

Your Cost: $250.26/claim|Median: $21.76
11.5× median
85027Top 1%

Complete blood count (CBC), automated

$1.4M

10K claims · 0.7%

Your Cost: $141.09/claim|Median: $3.72
37.9× median
97530Top 1%

Therapeutic activities, each 15 min

$1.4M

5K claims · 0.7%

Your Cost: $300.02/claim|Median: $33.11
9.1× median
99441Top 1%

Telephone E/M by physician, 5-10 min

$1.4M

2K claims · 0.7%

Your Cost: $667.32/claim|Median: $13.30
50.2× median
J7030Top 1%

Normal saline solution infusion, 1000 cc

$1.3M

5K claims · 0.7%

Your Cost: $273.89/claim|Median: $1.53
179.0× median
87631Top 1%

Respiratory virus detection, 3-5 targets, multiplex

$1.3M

4K claims · 0.7%

Your Cost: $366.37/claim|Median: $65.45
5.6× median
96372Top 1%

Therapeutic injection, subcutaneous/intramuscular

$1.3M

8K claims · 0.6%

Your Cost: $165.13/claim|Median: $9.56
17.3× median

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