Pyramid Health Care Inc.
Substance Abuse Rehabilitation Facility
Wilkinsburg, Pennsylvania
NPI: 1477674828
Risk Tier
Elevated
Total Paid
$128.8M
$128,752,810
Total Claims
423K
Beneficiaries
39K
Avg Cost/Claim
$304.62
Active billing period: 52 months (2020-09 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 $7.1M (2021) to $28.5M (2022) — a 301% swing with $21.4M absolute change.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 6.7x in 2022-06 — 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