Winslow Indian Health Care Center INC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $531.60 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity), which is 14.1× the national median of $37.81.
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:
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 $531.60 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity) — 14.1× the national median of $37.81.
Bills $430.17 per claim for 99211 (Office/outpatient visit, minimal complexity) — 33.3× the national median of $12.93.
Bills $64.71 per claim for S0215 (Non-invasive prenatal screening, fetal chromosomal abnormalities) — 3.0× the national median of $21.33.
Billing in the top 1% nationally for 2 procedure codes: 99213, 99211.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$121.2M
$121,157,577
Total Claims
235K
Beneficiaries
166K
1.4 claims/patient
Avg Cost/Claim
$516
#990 of 618K providers by total spending(top 0.2%)
🔍 Analysis
Provider Overview
Winslow Indian Health Care Center INC is a Clinic/Center Public Health Federal provider based in Winslow, AZ. From the 2018–2024 period, this provider received $121.2M in Medicaid payments across 235K claims.
Why This Matters
This provider received $121.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,144 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 17 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 100% of total spending.
$120.8M
227K claims
$531.60
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$120.8M
227K claims · 99.7%
$171K
397 claims
$430.17
$12.93
Office/outpatient visit, minimal complexity
$171K
397 claims · 0.1%
$65K
1K claims
$64.71
$21.33
Non-invasive prenatal screening, fetal chromosomal abnormalities
$65K
1K claims · 0.1%
$59K
2K claims
$31.16
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$59K
2K claims · 0.0%
$45K
1K claims
$40.34
$47.08
Ophthalmological exam, comprehensive, established patient
$45K
1K claims · 0.0%
$17K
396 claims
$41.79
$74.09
Office/outpatient visit, high complexity
$17K
396 claims · 0.0%
$13K
916 claims
$13.94
$25.06
Office/outpatient visit, low complexity
$13K
916 claims · 0.0%
Non-emergency mini-bus transport
$9K
1K claims · 0.0%
$3K
98 claims
$30.48
$22.44
Telephone E/M by physician, 11-20 minutes
$3K
98 claims · 0.0%
$2K
83 claims
$26.97
$36.13
Debridement, subcutaneous tissue, first 20 sq cm
$2K
83 claims · 0.0%
Telephone E/M by physician, 21-30 min
$2K
29 claims · 0.0%
$858
39 claims
$22.00
$13.30
Telephone E/M by physician, 5-10 min
$858
39 claims · 0.0%
Trimming of dystrophic nails, any number
$483
64 claims · 0.0%
Hemoglobin A1c (glycated hemoglobin)
$10
313 claims · 0.0%
$2
361 claims
$0.01
$1.40
Blood glucose test by monitoring device
$2
361 claims · 0.0%
Comprehensive metabolic panel
$0
37 claims · 0.0%
$0
13 claims · 0.0%
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