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

Driscoll Childrens Hospital

Speech-Language Pathologist, ·Corpus Christi, TX·NPI: 1548286172SharePrint 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 4.2x in 2021-07

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

Risk Assessment

Bills $259.72 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity) — 6.9× the national median of $37.81.

Bills $434.98 per claim for 99284 (Emergency dept visit, high complexity) — 6.3× the national median of $69.51.

Bills $180.18 per claim for 99212 (Office/outpatient visit, low complexity) — 7.2× the national median of $25.06.

Billing in the top 1% nationally for 20 procedure codes: 99213, 80053, 69436.

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

Compared to Speech-Language Pathologist, Peers

Total spending distribution among 30 providers in this specialty

P25MedianP75P90

This provider's total spending of $133.1M is at the 99th percentile among 30 Speech-Language Pathologist, providers.

Above 99th percentile for this specialty — higher spending than 29 of 30 peers

Active Billing Period:2020-012024-12(60 months)

Total Paid

$133.1M

$133,069,160

Total Claims

973K

Beneficiaries

822K

1.2 claims/patient

Avg Cost/Claim

$137

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

🔍 Analysis

Provider Overview

Driscoll Childrens Hospital is a Speech-Language Pathologist, provider based in Corpus Christi, TX. From the 2018–2024 period, this provider received $133.1M in Medicaid payments across 973K claims.

Why This Matters

This provider received $133.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,633 Medicaid beneficiaries for a full year at average per-enrollee costs.

1006% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2020
$2.6M
+825%
2021
$24.1M
+41%
2022
$34.0M
+28%
2023
$43.4M
-34%
2024
$28.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 12% of total spending.

99213Top 1%

Office/outpatient visit, est. patient, low-mod complexity

$15.4M

59K claims · 11.6%

Your Cost: $259.72/claim|Median: $37.81
6.9× median
99284Top 5%

Emergency dept visit, high complexity

$11.0M

25K claims · 8.3%

Your Cost: $434.98/claim|Median: $69.51
6.3× median
99212Top 5%

Office/outpatient visit, low complexity

$10.8M

60K claims · 8.1%

Your Cost: $180.18/claim|Median: $25.06
7.2× median
92507Top 5%

Speech/hearing/language treatment

$7.6M

51K claims · 5.7%

Your Cost: $148.75/claim|Median: $49.45
3.0× median
80053Top 1%

Comprehensive metabolic panel

$6.3M

24K claims · 4.8%

Your Cost: $261.79/claim|Median: $7.24
36.2× median
69436Top 1%

Tympanostomy, general anesthesia

$6.0M

3K claims · 4.5%

Your Cost: $2,403.71/claim|Median: $205.50
11.7× median
42820Top 5%

Tonsillectomy and adenoidectomy, under age 12

$5.7M

1K claims · 4.3%

Your Cost: $4,618.93/claim|Median: $331.68
13.9× median
93303Top 1%

Echocardiography, transthoracic, limited

$5.5M

3K claims · 4.2%

Your Cost: $1,887.30/claim|Median: $112.83
16.7× median
99283Top 25%

Emergency dept visit, moderate complexity

$5.0M

66K claims · 3.8%

Your Cost: $76.48/claim|Median: $42.48
1.8× median
99211Top 5%

Office/outpatient visit, minimal complexity

$4.2M

34K claims · 3.1%

Your Cost: $121.81/claim|Median: $12.93
9.4× median
99214Top 1%

Office/outpatient visit, est. patient, mod-high complexity

$3.3M

10K claims · 2.4%

Your Cost: $333.12/claim|Median: $53.41
6.2× median
99285Top 1%

Emergency dept visit, high/urgent complexity

$3.1M

5K claims · 2.3%

Your Cost: $620.75/claim|Median: $85.65
7.3× median
93306Top 1%

Echocardiography, transthoracic, complete, with Doppler

$2.6M

2K claims · 1.9%

Your Cost: $1,136.35/claim|Median: $54.68
20.8× median
93005Top 1%

Electrocardiogram, tracing only, without interpretation

$2.5M

12K claims · 1.9%

Your Cost: $206.22/claim|Median: $7.50
27.5× median
87804Top 1%

Influenza virus detection, rapid test

$2.3M

19K claims · 1.8%

Your Cost: $125.37/claim|Median: $12.59
10.0× median
97530Top 1%

Therapeutic activities, each 15 min

$2.2M

11K claims · 1.7%

Your Cost: $191.78/claim|Median: $33.11
5.8× median
80050Top 1%

General health panel

$2.0M

3K claims · 1.5%

Your Cost: $653.25/claim|Median: $25.59
25.5× median
76825Top 1%

$1.9M

657 claims · 1.4%

Your Cost: $2,834.59/claim|Median: $103.74
27.3× median
42830Top 1%

$1.6M

404 claims · 1.2%

Your Cost: $3,933.96/claim|Median: $341.04
11.5× median
76770Top 1%

Ultrasound, retroperitoneal, complete

$1.6M

3K claims · 1.2%

Your Cost: $610.22/claim|Median: $37.35
16.3× median
95810Top 1%

Polysomnography, sleep study, 6+ hours

$1.5M

609 claims · 1.1%

Your Cost: $2,424.86/claim|Median: $233.73
10.4× median
80061Top 1%

Lipid panel

$1.5M

5K claims · 1.1%

Your Cost: $276.67/claim|Median: $8.41
32.9× median
72082Top 1%

$1.4M

3K claims · 1.0%

Your Cost: $540.77/claim|Median: $31.02
17.4× median
87651Top 10%

Streptococcus Group A detection, nucleic acid, amplified probe

$1.2M

24K claims · 0.9%

Your Cost: $47.88/claim|Median: $28.46
1.7× median
84443Top 1%

Thyroid stimulating hormone (TSH)

$1.1M

6K claims · 0.8%

Your Cost: $189.33/claim|Median: $9.87
19.2× median
93320Top 1%

$1.1M

963 claims · 0.8%

Your Cost: $1,136.83/claim|Median: $28.68
39.6× median
82306Top 5%

Vitamin D, 25 hydroxy

$1.1M

10K claims · 0.8%

Your Cost: $104.63/claim|Median: $18.18
5.8× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$1.0M

31K claims · 0.8%

Your Cost: $32.83/claim|Median: $39.70
0.8× median
84439Top 1%

Free thyroxine level blood test

$979K

10K claims · 0.7%

Your Cost: $102.30/claim|Median: $6.31
16.2× median
81001Top 5%

Urinalysis, automated, with microscopy

$963K

25K claims · 0.7%

Your Cost: $38.96/claim|Median: $2.03
19.2× median

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