Premium Health Inc.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $4.2M (2022) to $19.3M (2023) — a 354% swing with $15.0M absolute change.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Clinic/Center Federally Qualified Health Center (FQHC) Peers
Total spending distribution among 24 providers in this specialty
This provider's total spending of $85.5M is at the below 25th percentile among 24 Clinic/Center Federally Qualified Health Center (FQHC) providers.
Total Paid
$85.5M
$85,468,495
Total Claims
710K
Beneficiaries
439K
1.6 claims/patient
Avg Cost/Claim
$120
🔍 Analysis
Provider Overview
Premium Health Inc. is a Clinic/Center Federally Qualified Health Center (FQHC) provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $85.5M in Medicaid payments across 710K claims.
Why This Matters
At $85.5M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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