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

Northeast Pennsylvania Center for Independent Living

Supports Brokerage·Scranton, PA·NPI: 1659601979SharePrint 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.

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 4.9x in 2018-12

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

Compared to Supports Brokerage Peers

Total spending distribution among 14 providers in this specialty

P25MedianP75P90

This provider's total spending of $227.2M is at the 25th percentile among 14 Supports Brokerage providers.

Active Billing Period:2018-012024-11(83 months)

Total Paid

$227.2M

$227,192,119

Total Claims

3.2M

Beneficiaries

181K

17.8 claims/patient

Avg Cost/Claim

$70

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

🔍 Analysis

Provider Overview

Northeast Pennsylvania Center for Independent Living is a Supports Brokerage provider based in Scranton, PA. From the 2018–2024 period, this provider received $227.2M in Medicaid payments across 3.2M claims.

Why This Matters

This provider received $227.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 28,399 Medicaid beneficiaries for a full year at average per-enrollee costs.

271% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$9.1M
+272%
2019
$33.7M
+1%
2020
$34.0M
+19%
2021
$40.3M
-13%
2022
$34.9M
+19%
2023
$41.6M
-19%
2024
$33.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 7 distinct procedure codes. The top code (S5126 (Attendant care services, per diem)) accounts for 60% of total spending.

S5126Normal range

Attendant care services, per diem

$135.5M

1.9M claims · 59.7%

Your Cost: $72.02/claim|Median: $156.98
0.5× median
S5125Normal range

Attendant care services, per 15 min

$32.7M

410K claims · 14.4%

Your Cost: $79.66/claim|Median: $82.34
1.0× median
S5150Normal range

Unskilled respite care, per 15 min

$28.2M

424K claims · 12.4%

Your Cost: $66.57/claim|Median: $84.46
0.8× median
T2041Normal range

Supports brokerage, self-directed; per 15 min

$27.6M

493K claims · 12.1%

Your Cost: $55.87/claim|Median: $162.29
0.3× median
G2021Top 25%

Health care common procedure coding system HCPCS lvl II

$1.8M

2K claims · 0.8%

Your Cost: $1,108.00/claim|Median: $856.03
1.3× median
T2040Normal range

Financial management, self-directed; per month

$1.2M

15K claims · 0.5%

Your Cost: $79.98/claim|Median: $108.97
0.7× median
W1793Top 25%

State-defined waiver service

$246K

1K claims · 0.1%

Your Cost: $187.95/claim|Median: $170.32
1.1× median