Circle of Care for Families & Children Inc.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T2023 (1 unique codes).
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
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:
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.
Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $60.3M is at the 25th percentile among 137 Case Management providers.
Total Paid
$60.3M
$60,276,698
Total Claims
67K
Beneficiaries
67K
1.0 claims/patient
Avg Cost/Claim
$897
🔍 Analysis
Provider Overview
Circle of Care for Families & Children Inc. is a Case Management provider based in Wayne, NJ. From the 2018–2024 period, this provider received $60.3M in Medicaid payments across 67K claims.
Important Context
- ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.
Why This Matters
At $60.3M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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