Brightview LLC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $176.81 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication), which is 22.5× the national median of $7.86.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 5 procedure codes: S5000 at 28.9× median, T1502 at 22.5× median.
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
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.
Risk Assessment
Bills $216.20 per claim for S5000 (Prescription drug, generic) — 28.9× the national median of $7.47.
Bills $176.81 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication) — 22.5× the national median of $7.86.
Billing in the top 1% nationally for 1 procedure code: T1502.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$501.1M
$501,081,514
Total Claims
7.9M
Beneficiaries
5.0M
1.6 claims/patient
Avg Cost/Claim
$63
#122 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Brightview LLC is a Internal Medicine Addiction Medicine provider based in Cincinnati, OH. From the 2018–2024 period, this provider received $501.1M in Medicaid payments across 7.9M claims.
Why This Matters
This provider received $501.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 62,635 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 30 distinct procedure codes. The top code (S5000 (Prescription drug, generic)) accounts for 21% of total spending.
Prescription drug, generic
$105.1M
486K claims · 21.0%
$94.8M
536K claims
$176.81
$7.86
Administration of oral, intramuscular, or subcutaneous medication
$94.8M
536K claims · 18.9%
$72.2M
714K claims
$101.11
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$72.2M
714K claims · 14.4%
$39.2M
861K claims
$45.48
$35.43
Drug test, presumptive, by chemistry analyzers
$39.2M
861K claims · 7.8%
$30.1M
225K claims
$133.86
$90.89
Drug test, definitive, 22+ drug classes
$30.1M
225K claims · 6.0%
$27.7M
244K claims
$113.65
$75.26
Drug test, definitive, 15-21 drug classes
$27.7M
244K claims · 5.5%
$26.7M
107K claims · 5.3%
Psychotherapy, 60 minutes
$11.8M
126K claims · 2.4%
$9.5M
141K claims
$67.75
$47.35
Alcohol and/or drug services, group counseling
$9.5M
141K claims · 1.9%
$8.5M
128K claims
$66.49
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$8.5M
128K claims · 1.7%
Psychotherapy, 30 minutes
$7.1M
154K claims · 1.4%
$6.2M
239K claims
$26.13
$43.10
Alcohol and/or drug services, case management
$6.2M
239K claims · 1.2%
Psychotherapy, 45 minutes
$5.8M
93K claims · 1.2%
$5.3M
20K claims
$270.57
$300.13
Community transition, waiver; per service
$5.3M
20K claims · 1.1%
$3.8M
441K claims · 0.8%
$3.8M
44K claims
$86.59
$64.72
Drug test, definitive, 8-14 drug classes
$3.8M
44K claims · 0.8%
$3.0M
110K claims
$27.55
$18.95
Alcohol/drug services; methadone administration
$3.0M
110K claims · 0.6%
$2.1M
123K claims · 0.4%
RN services, per 15 minutes
$2.0M
59K claims · 0.4%
$1.9M
127K claims · 0.4%
$1.7M
75K claims · 0.3%
$1.7M
13K claims
$129.11
$84.03
Office/outpatient visit, new patient, mod-high complexity
$1.7M
13K claims · 0.3%
$1.7M
34K claims
$49.72
$64.10
Alcohol/drug services, treatment plan review
$1.7M
34K claims · 0.3%
$1.2M
6K claims
$193.84
$111.09
Office/outpatient visit, new patient, high complexity
$1.2M
6K claims · 0.2%
$1.0M
127K claims
$8.21
$5.78
Benzodiazepine drug assay by definitive method
$1.0M
127K claims · 0.2%
$1.0M
126K claims · 0.2%
$1.0M
127K claims · 0.2%
$1.0M
126K claims · 0.2%
$1.0M
125K claims · 0.2%
$1.0M
123K claims · 0.2%
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