Consumer Direct Care Network Virginia
Home Health
Missoula, Montana
NPI: 1538649983
Risk Tier
Critical
Total Paid
$2.11B
$2,105,798,329
Total Claims
22.2M
Beneficiaries
1.1M
Avg Cost/Claim
$95.02
Active billing period: 78 months (2018-07 to 2024-12)
Statistical Fraud Flags (4)
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $5.9M (2018) to $150.4M (2019) — a 2439% swing with $144.5M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 2439% from 2018 to 2019.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
Spending Spike
Experienced a dramatic increase in billing over a short period.
Advanced Detection Signals
Billing Velocity
12915.2 claims per working day — may exceed physically possible volume for a single provider.
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