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

Apple Homecare Medical Supply LLC

Durable Medical Equipment & Medical Supplies, Customized Equipment·Richardson, TX·NPI: 1649259797SharePrint Report
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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:

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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.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Change PointBilling shifted 33.8x in 2020-10

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

Risk Assessment

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Bills $1,446.43 per claim for B4153 — 3.5× the national median of $410.73.

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Bills $281.52 per claim for B4155 — 6.0× the national median of $46.72.

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Bills $436.82 per claim for E1399 (Durable medical equipment, miscellaneous) — 4.2× the national median of $104.06.

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Billing in the top 1% nationally for 1 procedure code: B4152.

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

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$123.3M

$123,283,401

Total Claims

1.1M

Beneficiaries

995K

1.1 claims/patient

Avg Cost/Claim

$114

#967 of 618K providers by total spending(top 0.2%)

🔍 Analysis

Provider Overview

Apple Homecare Medical Supply LLC is a Durable Medical Equipment & Medical Supplies, Customized Equipment provider based in Richardson, TX. From the 2018–2024 period, this provider received $123.3M in Medicaid payments across 1.1M claims.

Why This Matters

This provider received $123.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,410 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 10054% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$279K
-55%
2019
$125K
+6234%
2020
$7.9M
+251%
2021
$27.8M
+1%
2022
$28.2M
+9%
2023
$30.7M
-8%
2024
$28.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (B4161 (Enteral formula, semisolid, 100 calories = 1 unit)) accounts for 12% of total spending.

B4161Top 25%

Enteral formula, semisolid, 100 calories = 1 unit

$15.3M

20K claims · 12.4%

Your Cost: $765.51/claim|Median: $465.86
1.6× median
B4035Top 5%

Enteral feeding supply kit, pump fed, per day

$14.2M

53K claims · 11.5%

Your Cost: $266.09/claim|Median: $117.24
2.3× median
E0465Normal range

Home ventilator, any type, used with invasive interface

$12.8M

18K claims · 10.4%

Your Cost: $694.96/claim|Median: $583.21
1.2× median
B9998Normal range

Enteral/parenteral nutritional supplies, NOS

$6.6M

75K claims · 5.4%

Your Cost: $88.42/claim|Median: $55.51
1.6× median
B4160Top 10%

Enteral formula, per 100 calories

$6.4M

21K claims · 5.2%

Your Cost: $308.20/claim|Median: $157.30
2.0× median
E1390Top 5%

Oxygen concentrator, single delivery port

$5.5M

47K claims · 4.5%

Your Cost: $116.14/claim|Median: $45.11
2.6× median
B4149Top 25%

Enteral formula, manufactured blenderized, per 100 calories

$4.9M

12K claims · 4.0%

Your Cost: $394.59/claim|Median: $300.16
1.3× median
E0466Top 5%

Home ventilator, any type, used with non-invasive interface

$4.8M

6K claims · 3.9%

Your Cost: $758.15/claim|Median: $317.50
2.4× median
B4153Top 5%

$4.8M

3K claims · 3.9%

Your Cost: $1,446.43/claim|Median: $410.73
3.5× median
A4606Normal range

$3.7M

51K claims · 3.0%

Your Cost: $72.81/claim|Median: $50.63
1.4× median
E0482Normal range

$3.0M

12K claims · 2.4%

Your Cost: $257.93/claim|Median: $246.17
1.1× median
B4155Top 10%

$2.9M

10K claims · 2.3%

Your Cost: $281.52/claim|Median: $46.72
6.0× median
E1399Normal range

Durable medical equipment, miscellaneous

$2.7M

6K claims · 2.2%

Your Cost: $436.82/claim|Median: $104.06
4.2× median
E0445Normal range

$2.3M

16K claims · 1.9%

Your Cost: $140.97/claim|Median: $118.11
1.2× median
A4605Normal range

$2.2M

10K claims · 1.8%

Your Cost: $221.09/claim|Median: $121.51
1.8× median
A4353Top 25%

Intermittent urinary catheter, with insertion supplies

$1.7M

3K claims · 1.4%

Your Cost: $663.60/claim|Median: $508.29
1.3× median
B4150Top 5%

Enteral formula, nutritionally complete with fiber, per 100 calories

$1.6M

6K claims · 1.3%

Your Cost: $286.90/claim|Median: $89.79
3.2× median
A7000Top 5%

$1.5M

36K claims · 1.2%

Your Cost: $41.75/claim|Median: $11.83
3.5× median
A4624Normal range

$1.5M

12K claims · 1.2%

Your Cost: $128.40/claim|Median: $107.53
1.2× median
A4554Normal range

Disposable underpads, all sizes

$1.3M

44K claims · 1.0%

Your Cost: $29.19/claim|Median: $37.02
0.8× median
A4629Top 25%

$1.3M

15K claims · 1.0%

Your Cost: $85.93/claim|Median: $54.42
1.6× median
T4532Top 25%

$1.2M

8K claims · 1.0%

Your Cost: $146.25/claim|Median: $116.50
1.3× median
B9002Top 25%

$1.1M

14K claims · 0.9%

Your Cost: $80.57/claim|Median: $54.41
1.5× median
B4152Top 1%

Enteral formula, calorically dense, per 100 calories

$1.1M

3K claims · 0.9%

Your Cost: $377.82/claim|Median: $92.20
4.1× median
A6210Normal range

$1.0M

4K claims · 0.8%

Your Cost: $250.42/claim|Median: $163.78
1.5× median
A7520Top 25%

$994K

13K claims · 0.8%

Your Cost: $79.54/claim|Median: $49.59
1.6× median
A6209Top 25%

$988K

8K claims · 0.8%

Your Cost: $131.20/claim|Median: $55.36
2.4× median
A7521Top 25%

$965K

8K claims · 0.8%

Your Cost: $126.83/claim|Median: $39.24
3.2× median
E0431Top 25%

Portable gaseous oxygen system, rental

$953K

48K claims · 0.8%

Your Cost: $20.02/claim|Median: $10.37
1.9× median
T4522Top 25%

Adult-sized disposable incontinence product, brief/diaper, above XL

$893K

9K claims · 0.7%

Your Cost: $102.22/claim|Median: $84.50
1.2× median

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