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

Saltzman Tanis Pittell Levin and Jacobson

Pediatrics

Hollywood, Florida

NPI: 1639138480

Risk Tier

Critical

Total Paid

$201.3M

$201,288,692

Total Claims

19.1M

Beneficiaries

18.0M

Avg Cost/Claim

$10.53

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (3)

Billing Swing

Experienced over 200% change in year-over-year billing with >$1M absolute change.

Billing changed from $1.7M (2018) to $15.5M (2019) — a 837% swing with $13.9M absolute change.

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 7 procedure codes: 99204 at 1.7× median, 69000 at 1.4× median.

Explosive Growth

Billing increased over 500% year-over-year — far beyond normal growth patterns.

Billing grew 837% from 2018 to 2019.

Advanced Detection Signals

Billing Velocity

10348.3 claims per working day — may exceed physically possible volume for a single provider.

CUSUM Change Point

Billing shifted 3.5x in 2021-05 — a statistically significant structural change in billing behavior was detected.

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