Northeast Pennsylvania Center for Independent Living
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $9.1M (2018) to $33.7M (2019) — a 272% swing with $24.7M 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.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
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
This provider's total spending of $227.2M is at the 25th percentile among 14 Supports Brokerage providers.
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.
Monthly Spending Trend
Yearly Spending
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.
$135.5M
1.9M claims
$72.02
$156.98
Attendant care services, per diem
$135.5M
1.9M claims · 59.7%
$32.7M
410K claims
$79.66
$82.34
Attendant care services, per 15 min
$32.7M
410K claims · 14.4%
$28.2M
424K claims
$66.57
$84.46
Unskilled respite care, per 15 min
$28.2M
424K claims · 12.4%
$27.6M
493K claims
$55.87
$162.29
Supports brokerage, self-directed; per 15 min
$27.6M
493K claims · 12.1%
$1.8M
2K claims
$1,108.00
$856.03
Health care common procedure coding system HCPCS lvl II
$1.8M
2K claims · 0.8%
$1.2M
15K claims
$79.98
$108.97
Financial management, self-directed; per month
$1.2M
15K claims · 0.5%
State-defined waiver service
$246K
1K claims · 0.1%
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