Genedx LLC
Medical Genetics, Ph.D. Medical Genetics
Gaithersburg, Maryland
NPI: 1487632998
Risk Tier
Elevated
Total Paid
$215.3M
$215,335,419
Total Claims
446K
Beneficiaries
386K
Avg Cost/Claim
$483.23
Active billing period: 84 months (2018-01 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 13 procedure codes: 81470 at 1.2× median, 81471 at 1.0× median.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 6.8x in 2022-01 — 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