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

Guardiantrac. LLC

Community/Behavioral Health·Sturgis, MI·NPI: 1710176151SharePrint 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:

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.

Unusually High Spending

Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.

High Claims Per Patient

High Claims Per Patient means this provider files an unusually high number of claims per individual patient. This could indicate legitimate intensive treatment or a pattern of billing for services not actually rendered.

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

Billing Velocity19241.1 claims/working day

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

Risk Assessment

Bills $226.43 per claim for T1002 (RN services, per 15 minutes) — 6.0× the national median of $37.42.

Billing above the 90th percentile for 3 procedure codes simultaneously.

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

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $2.68B is at the 99th percentile among 218 Community/Behavioral Health providers.

Above 99th percentile for this specialty — higher spending than 215 of 218 peers

Active Billing Period:2018-012024-12(84 months)

Total Paid

$2.68B

$2,683,634,592

Total Claims

35.6M

Beneficiaries

2.4M

14.6 claims/patient

Avg Cost/Claim

$75

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

🔍 Analysis

Provider Overview

Guardiantrac. LLC is a Community/Behavioral Health provider based in Sturgis, MI. From the 2018–2024 period, this provider received $2.7B in Medicaid payments across 35.6M claims.

Why This Matters

This provider received $2.7B in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 335,454 Medicaid beneficiaries for a full year at average per-enrollee costs.

214% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$147.3M
+48%
2019
$218.4M
+48%
2020
$322.8M
+15%
2021
$371.6M
+26%
2022
$469.4M
+47%
2023
$691.3M
-33%
2024
$462.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 31% of total spending.

T1019Normal range

Personal care services, per 15 min

$825.6M

12.4M claims · 30.8%

Your Cost: $66.68/claim|Median: $82.47
0.8× median
S5135Top 25%

Companion care, adult, per diem

$649.1M

6.1M claims · 24.2%

Your Cost: $106.25/claim|Median: $52.25
2.0× median
S5125Normal range

Attendant care services, per 15 min

$262.5M

4.1M claims · 9.8%

Your Cost: $64.53/claim|Median: $82.34
0.8× median
S5130Normal range

Homemaker service, NOS; per 15 min

$208.0M

5.9M claims · 7.8%

Your Cost: $35.01/claim|Median: $48.76
0.7× median
H2015Normal range

Comprehensive community support services, per 15 min

$201.7M

2.3M claims · 7.5%

Your Cost: $89.08/claim|Median: $96.24
0.9× median
T2027Normal range

Specialized transportation, waiver, per trip, extra

$79.7M

724K claims · 3.0%

Your Cost: $110.18/claim|Median: $88.93
1.2× median
S5126Normal range

Attendant care services, per diem

$68.6M

234K claims · 2.6%

Your Cost: $293.41/claim|Median: $156.98
1.9× median
T2013Normal range

Habilitation, residential, waiver, per hour

$52.6M

328K claims · 2.0%

Your Cost: $160.35/claim|Median: $158.23
1.0× median
S5150Normal range

Unskilled respite care, per 15 min

$38.0M

369K claims · 1.4%

Your Cost: $102.88/claim|Median: $84.46
1.2× median
T2040Normal range

Financial management, self-directed; per month

$37.6M

427K claims · 1.4%

Your Cost: $88.18/claim|Median: $108.97
0.8× median
S5131Normal range

Homemaker service, NOS, per diem

$33.7M

145K claims · 1.3%

Your Cost: $232.36/claim|Median: $102.01
2.3× median
T1005Normal range

Respite care services, per 15 minutes

$30.2M

371K claims · 1.1%

Your Cost: $81.34/claim|Median: $71.40
1.1× median
T2025Normal range

Waiver services, NOS; per 15 min

$23.6M

233K claims · 0.9%

Your Cost: $101.10/claim|Median: $124.39
0.8× median
T2019Normal range

Habilitation, prevocational, waiver; per 15 min

$23.2M

261K claims · 0.9%

Your Cost: $88.57/claim|Median: $88.91
1.0× median
T2028Normal range

Specialized supply, NOS; per unit

$22.4M

184K claims · 0.8%

Your Cost: $121.67/claim|Median: $79.30
1.5× median
T2021Normal range

Day habilitation, waiver; per 15 min

$21.3M

246K claims · 0.8%

Your Cost: $86.67/claim|Median: $150.51
0.6× median
T1004Top 5%

Services of a qualified nursing aide, per 15 minutes

$17.5M

137K claims · 0.7%

Your Cost: $127.49/claim|Median: $50.30
2.5× median
T2003Top 25%

Non-emergency transport; encounter/trip

$12.6M

264K claims · 0.5%

Your Cost: $47.93/claim|Median: $21.70
2.2× median
H0043Normal range

Supported housing, per diem

$10.9M

61K claims · 0.4%

Your Cost: $177.76/claim|Median: $164.87
1.1× median
T2017Normal range

Habilitation, residential, waiver; 15 min

$9.3M

59K claims · 0.3%

Your Cost: $156.81/claim|Median: $137.32
1.1× median
T2012Normal range

Habilitation, educational; per 15 min

$7.0M

42K claims · 0.3%

Your Cost: $167.10/claim|Median: $177.54
0.9× median
T2018Normal range

$6.3M

44K claims · 0.2%

Your Cost: $142.20/claim|Median: $117.28
1.2× median
T1002Top 10%

RN services, per 15 minutes

$4.3M

19K claims · 0.2%

Your Cost: $226.43/claim|Median: $37.42
6.0× median
S5136Normal range

Companion care, adult, per 15 minutes

$3.6M

57K claims · 0.1%

Your Cost: $62.86/claim|Median: $302.34
0.2× median
S0215Normal range

Non-invasive prenatal screening, fetal chromosomal abnormalities

$3.4M

163K claims · 0.1%

Your Cost: $20.60/claim|Median: $21.33
1.0× median
T2020Normal range

Day habilitation, waiver; per diem

$3.0M

32K claims · 0.1%

Your Cost: $91.68/claim|Median: $87.34
1.1× median
T2041Normal range

Supports brokerage, self-directed; per 15 min

$2.8M

45K claims · 0.1%

Your Cost: $63.35/claim|Median: $162.29
0.4× median
H2014Normal range

Skills training & development, per 15 min

$2.5M

36K claims · 0.1%

Your Cost: $67.50/claim|Median: $83.88
0.8× median
H2025Normal range

Ongoing support to maintain employment, per 15 min

$2.1M

19K claims · 0.1%

Your Cost: $110.16/claim|Median: $100.49
1.1× median
S5161Top 5%

Emergency response system, per month

$1.6M

18K claims · 0.1%

Your Cost: $87.96/claim|Median: $29.97
2.9× median