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

Srh Chn Lead Health Home LLC

Case Management

Peekskill, New York

NPI: 1750053948

Risk Tier

Critical

Total Paid

$239.0M

$238,967,731

Total Claims

756K

Beneficiaries

756K

Avg Cost/Claim

$316.11

Active billing period: 28 months (2022-09 to 2024-12)

Statistical Fraud Flags (5)

Cost Outlier

Billing over 3× the national median for specific procedure codes.

Bills $296.20 per claim for G9005 (Coordinated care fee, risk-adjusted, ESRD), which is 6.3× the national median of $47.08.

Billing Swing

Experienced over 200% change in year-over-year billing with >$1M absolute change.

Billing changed from $34.6M (2022) to $107.1M (2023) — a 209% swing with $72.5M absolute change.

New Entrant

Started billing recently but already receiving millions in Medicaid payments.

First appeared in 2022-09 and has already billed $239.0M, averaging $8.5M/month across 28 months.

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 2 procedure codes: T2022 at 3.0× median, G0506 at 25.1× median.

Instant Volume

New provider billing over $1M in their first year of Medicaid participation.

Billed $34.6M in first year (2022).

Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.

Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024