Alivia Specialty LLC
Pharmacy Specialty Pharmacy
Guaynabo, Puerto Rico
NPI: 1306182548
Risk Tier
Elevated
Total Paid
$189.0M
$188,981,224
Total Claims
105K
Beneficiaries
71K
Avg Cost/Claim
$1,798.04
Active billing period: 47 months (2019-10 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 26 procedure codes: J9271 at 2.0× median, J9035 at 105.3× median.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 5.0x in 2022-11 — 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