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

Community Alternatives Virginia Inc.

Community/Behavioral Health

Forest, Virginia

NPI: 1194020370

Risk Tier

Elevated

Total Paid

$172.7M

$172,726,466

Total Claims

23K

Beneficiaries

22K

Avg Cost/Claim

$7,534.09

Active billing period: 83 months (2018-01 to 2024-11)

Statistical Fraud Flags (1)

Cost Outlier

Billing over 3× the national median for specific procedure codes.

Bills $8,330.64 per claim for T2033 (Residential care, NOS; per diem), which is 7.9× the national median of $1,051.57.

Advanced Detection Signals

Suspicious Concentration

Herfindahl-Hirschman Index of 1 across 3 procedure codes — billing is highly concentrated in very few services.

Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.

Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024