Department of Intellectual and Developmental Disabilities, State of Tn
Public Health or Welfare
Nashville, Tennessee
NPI: 1629436241
Risk Tier
High
Total Paid
$2.60B
$2,596,064,455
Total Claims
16.3M
Beneficiaries
1.2M
Avg Cost/Claim
$158.79
Active billing period: 78 months (2018-01 to 2024-06)
Statistical Fraud Flags (2)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 20 procedure codes: D4341 at 6.8× median, S9470 at 6.3× median.
Consistent Billing
Monthly billing amounts show almost no natural variation (CV < 0.1).
Monthly billing coefficient of variation: 0.0777 (near-zero variation).
Advanced Detection Signals
Billing Velocity
9527.5 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