Systems Unlimited Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $4,610.55 per claim for S5136 (Companion care, adult, per 15 minutes), which is 15.2× the national median of $302.34.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: H2016 at 20.3× median, H2025 at 7.7× 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.
Risk Assessment
Bills $6,522.24 per claim for H2016 (Comprehensive community support services, per 15 min) — 20.3× the national median of $321.53.
Bills $4,610.55 per claim for S5136 (Companion care, adult, per 15 minutes) — 15.3× the national median of $302.34.
Bills $776.37 per claim for H2025 (Ongoing support to maintain employment, per 15 min) — 7.7× the national median of $100.49.
Billing above the 90th percentile for 4 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Day Training Developmentally Disabled Services Peers
Total spending distribution among 22 providers in this specialty
This provider's total spending of $244.8M is at the 90th percentile among 22 Day Training Developmentally Disabled Services providers.
Above 90th percentile for this specialty — higher spending than 19 of 22 peers
Total Paid
$244.8M
$244,753,416
Total Claims
161K
Beneficiaries
45K
3.6 claims/patient
Avg Cost/Claim
$2K
#338 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Systems Unlimited Inc. is a Day Training Developmentally Disabled Services provider based in Iowa City, IA. From the 2018–2024 period, this provider received $244.8M in Medicaid payments across 161K claims.
Why This Matters
This provider received $244.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 30,594 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 (H2016 (Comprehensive community support services, per 15 min)) accounts for 60% of total spending.
$146.6M
22K claims
$6,522.24
$321.53
Comprehensive community support services, per 15 min
$146.6M
22K claims · 59.9%
$82.7M
18K claims
$4,610.55
$302.34
Companion care, adult, per 15 minutes
$82.7M
18K claims · 33.8%
$5.4M
76K claims
$71.16
$150.51
Day habilitation, waiver; per 15 min
$5.4M
76K claims · 2.2%
$4.3M
6K claims
$776.37
$100.49
Ongoing support to maintain employment, per 15 min
$4.3M
6K claims · 1.7%
$2.9M
8K claims
$370.02
$96.24
Comprehensive community support services, per 15 min
$2.9M
8K claims · 1.2%
$2.7M
31K claims
$88.37
$87.34
Day habilitation, waiver; per diem
$2.7M
31K claims · 1.1%
Attendant care services, per 15 min
$136K
435 claims · 0.1%
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