City of Chicago
Ambulance
Chicago, Illinois
NPI: 1376554592
Risk Tier
Critical
Total Paid
$1.23B
$1,225,040,114
Total Claims
1.6M
Beneficiaries
1.2M
Avg Cost/Claim
$768.70
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (6)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $1,739.44 per claim for A0429 (Ambulance, BLS emergency transport), which is 12.6× the national median of $138.19.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $23.0M (2019) to $185.6M (2020) — a 706% swing with $162.6M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: A0427 at 9.8× median, A0429 at 12.6× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 706% from 2019 to 2020.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 6.1x in 2020-05 — 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