Topcare Medical Group INC
Pediatrics
Dallas, Texas
NPI: 1285016758
Risk Tier
Elevated
Total Paid
$160.4M
$160,363,652
Total Claims
8.4M
Beneficiaries
6.9M
Avg Cost/Claim
$19.01
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $6.3M (2020) to $32.6M (2021) — a 417% swing with $26.3M absolute change.
Advanced Detection Signals
Billing Velocity
4563.7 claims per working day — may exceed physically possible volume for a single provider.
CUSUM Change Point
Billing shifted 17.1x in 2020-12 — a statistically significant structural change in billing behavior was detected.
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