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

Pro Care Unlimited, INC

Home Health·Southfield, MI·NPI: 1518373703SharePrint 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:

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

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

Risk Assessment

Bills $857.96 per claim for T1019 (Personal care services, per 15 min) — 10.4× the national median of $82.47.

Bills $415.69 per claim for B4150 (Enteral formula, nutritionally complete with fiber, per 100 calories) — 4.6× the national median of $89.79.

Billing in the top 1% nationally for 1 procedure code: B4150.

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

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $216.3M is at the 50th percentile among 322 Home Health providers.

Active Billing Period:2018-012024-12(84 months)
Sharp billing drop in final month

Total Paid

$216.3M

$216,341,204

Total Claims

1.7M

Beneficiaries

119K

14.5 claims/patient

Avg Cost/Claim

$125

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

🔍 Analysis

Provider Overview

Pro Care Unlimited, INC is a Home Health provider based in Southfield, MI. From the 2018–2024 period, this provider received $216.3M in Medicaid payments across 1.7M claims.

Why This Matters

This provider received $216.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,042 Medicaid beneficiaries for a full year at average per-enrollee costs.

346% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$10.3M
+85%
2019
$19.0M
+47%
2020
$27.9M
+20%
2021
$33.4M
+11%
2022
$37.0M
+16%
2023
$43.0M
+7%
2024
$45.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 6 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 72% of total spending.

H2015Normal range

Comprehensive community support services, per 15 min

$154.7M

1.2M claims · 71.5%

Your Cost: $124.29/claim|Median: $96.24
1.3× median
T1019Top 5%

Personal care services, per 15 min

$31.4M

37K claims · 14.5%

Your Cost: $857.96/claim|Median: $82.47
10.4× median
T1005Normal range

Respite care services, per 15 minutes

$28.3M

442K claims · 13.1%

Your Cost: $63.93/claim|Median: $71.40
0.9× median
H0043Top 25%

Supported housing, per diem

$1.8M

4K claims · 0.8%

Your Cost: $419.99/claim|Median: $164.87
2.5× median
B4150Top 1%

Enteral formula, nutritionally complete with fiber, per 100 calories

$74K

177 claims · 0.0%

Your Cost: $415.69/claim|Median: $89.79
4.6× median
S0215Normal range

Non-invasive prenatal screening, fetal chromosomal abnormalities

$14K

427 claims · 0.0%

Your Cost: $31.79/claim|Median: $21.33
1.5× median