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

Johns Hopkins All Children's Hospital INC

General Acute Care Hospital Children·St Petersburg, FL·NPI: 1427114099SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Change PointBilling shifted 23.5x in 2018-12

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $257.15 per claim for 92507 (Speech/hearing/language treatment) — 5.2× the national median of $49.45.

Bills $223.34 per claim for 99283 (Emergency dept visit, moderate complexity) — 5.3× the national median of $42.48.

Bills $170.48 per claim for 97110 (Therapeutic exercises, each 15 min) — 7.0× the national median of $24.49.

Billing in the top 1% nationally for 7 procedure codes: 92507, 97110, 97530.

This is a statistical summary, not an accusation. See our methodology.

Compared to General Acute Care Hospital Children Peers

Total spending distribution among 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $152.8M is at the 25th percentile among 16 General Acute Care Hospital Children providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$152.8M

$152,824,919

Total Claims

1.4M

Beneficiaries

1.1M

1.3 claims/patient

Avg Cost/Claim

$107

#704 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Johns Hopkins All Children's Hospital INC is a General Acute Care Hospital Children provider based in St Petersburg, FL. From the 2018–2024 period, this provider received $152.8M in Medicaid payments across 1.4M claims.

Why This Matters

This provider received $152.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,103 Medicaid beneficiaries for a full year at average per-enrollee costs.

920% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$1.0M
+3128%
2019
$33.7M
-19%
2020
$27.3M
+29%
2021
$35.1M
-30%
2022
$24.4M
-16%
2023
$20.6M
-48%
2024
$10.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (92507 (Speech/hearing/language treatment)) accounts for 18% of total spending.

92507Top 1%

Speech/hearing/language treatment

$27.2M

106K claims · 17.8%

Your Cost: $257.15/claim|Median: $49.45
5.2× median
99283Top 5%

Emergency dept visit, moderate complexity

$19.0M

85K claims · 12.4%

Your Cost: $223.34/claim|Median: $42.48
5.3× median
97110Top 1%

Therapeutic exercises, each 15 min

$13.9M

82K claims · 9.1%

Your Cost: $170.48/claim|Median: $24.49
7.0× median
99284Top 5%

Emergency dept visit, high complexity

$11.0M

38K claims · 7.2%

Your Cost: $289.62/claim|Median: $69.51
4.2× median
97530Top 1%

Therapeutic activities, each 15 min

$8.4M

53K claims · 5.5%

Your Cost: $159.66/claim|Median: $33.11
4.8× median
93303Top 5%

Echocardiography, transthoracic, limited

$4.8M

7K claims · 3.1%

Your Cost: $723.31/claim|Median: $112.83
6.4× median
93306Top 1%

Echocardiography, transthoracic, complete, with Doppler

$4.6M

8K claims · 3.0%

Your Cost: $555.82/claim|Median: $54.68
10.2× median
80053Top 5%

Comprehensive metabolic panel

$4.4M

44K claims · 2.8%

Your Cost: $97.80/claim|Median: $7.24
13.5× median
99282Top 5%

Emergency dept visit, low complexity

$3.3M

16K claims · 2.2%

Your Cost: $204.10/claim|Median: $37.72
5.4× median
G0378Normal range

Hospital observation service, per hour

$2.1M

12K claims · 1.4%

Your Cost: $179.51/claim|Median: $99.39
1.8× median
92523Top 5%

Evaluation of speech sound production with language comprehension

$2.1M

8K claims · 1.4%

Your Cost: $249.79/claim|Median: $110.87
2.3× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$1.9M

8K claims · 1.2%

Your Cost: $248.79/claim|Median: $85.65
2.9× median
95810Top 5%

Polysomnography, sleep study, 6+ hours

$1.7M

2K claims · 1.1%

Your Cost: $1,001.41/claim|Median: $233.73
4.3× median
U0003Top 10%

Infectious disease detection (COVID-19)

$1.7M

17K claims · 1.1%

Your Cost: $99.74/claim|Median: $63.08
1.6× median
J1569Normal range

$1.6M

801 claims · 1.0%

Your Cost: $1,994.29/claim|Median: $1,387.65
1.4× median
94375Top 1%

$1.6M

11K claims · 1.0%

Your Cost: $136.40/claim|Median: $17.23
7.9× median
96365Top 1%

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$1.5M

4K claims · 1.0%

Your Cost: $436.75/claim|Median: $54.77
8.0× median
T1017Normal range

Targeted case management, per 15 min

$1.5M

60K claims · 1.0%

Your Cost: $25.50/claim|Median: $69.56
0.4× median
92526Top 5%

Treatment of swallowing dysfunction and/or oral function

$1.5M

12K claims · 1.0%

Your Cost: $125.57/claim|Median: $49.74
2.5× median
70551Top 25%

MRI brain without contrast

$1.2M

5K claims · 0.8%

Your Cost: $241.56/claim|Median: $85.39
2.8× median
95782Top 25%

$966K

973 claims · 0.6%

Your Cost: $992.99/claim|Median: $216.35
4.6× median
54161Normal range

$721K

1K claims · 0.5%

Your Cost: $680.16/claim|Median: $252.63
2.7× median
87086Top 5%

Urine culture, colony count, with identification

$708K

15K claims · 0.5%

Your Cost: $47.70/claim|Median: $5.31
9.0× median
97162Top 1%

PT evaluation, moderate complexity

$690K

2K claims · 0.5%

Your Cost: $327.26/claim|Median: $46.10
7.1× median
82657Top 5%

$665K

3K claims · 0.4%

Your Cost: $220.76/claim|Median: $15.70
14.1× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$662K

631 claims · 0.4%

Your Cost: $1,048.45/claim|Median: $1,587.53
0.7× median
70450Top 10%

CT head/brain without contrast

$647K

3K claims · 0.4%

Your Cost: $220.07/claim|Median: $45.53
4.8× median
96374Top 25%

Therapeutic/prophylactic/diagnostic IV push, single substance

$629K

6K claims · 0.4%

Your Cost: $101.00/claim|Median: $21.76
4.6× median
87804Top 5%

Influenza virus detection, rapid test

$624K

11K claims · 0.4%

Your Cost: $55.75/claim|Median: $12.59
4.4× median
96360Top 25%

IV infusion, hydration, initial, 31 minutes to 1 hour

$621K

4K claims · 0.4%

Your Cost: $169.84/claim|Median: $61.57
2.8× median