Park Nicollet Clinic
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $9.7M (2018) to $37.9M (2019) — a 292% swing with $28.2M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 32 procedure codes: S0302 at 5.9× median, G0439 at 11.9× 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:
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.
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 $53.58 per claim for S0302 — 5.9× the national median of $9.05.
This is a statistical summary, not an accusation. See our methodology.
Compared to Obstetrics & Gynecology Peers
Total spending distribution among 5 providers in this specialty
This provider's total spending of $209.7M is at the 99th percentile among 5 Obstetrics & Gynecology providers.
Above 99th percentile for this specialty — higher spending than 4 of 5 peers
Total Paid
$209.7M
$209,657,270
Total Claims
6.0M
Beneficiaries
5.3M
1.1 claims/patient
Avg Cost/Claim
$35
#421 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Park Nicollet Clinic is a Obstetrics & Gynecology provider based in St Louis Park, MN. From the 2018–2024 period, this provider received $209.7M in Medicaid payments across 6.0M claims.
Why This Matters
This provider received $209.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,207 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 (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 19% of total spending.
$39.0M
560K claims
$69.68
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$39.0M
560K claims · 18.6%
$30.0M
607K claims
$49.43
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$30.0M
607K claims · 14.3%
$8.4M
156K claims · 4.0%
$5.6M
63K claims
$89.83
$74.09
Office/outpatient visit, high complexity
$5.6M
63K claims · 2.7%
$4.5M
72K claims
$62.53
$57.85
Office/outpatient visit, new patient, low-mod complexity
$4.5M
72K claims · 2.1%
$4.3M
46K claims
$94.50
$84.03
Office/outpatient visit, new patient, mod-high complexity
$4.3M
46K claims · 2.1%
$4.0M
60K claims
$67.15
$75.18
Preventive medicine, established patient, age 1-4
$4.0M
60K claims · 1.9%
Psychotherapy, 45 minutes
$3.6M
65K claims · 1.7%
$3.3M
72K claims · 1.6%
$3.0M
55K claims
$55.95
$69.35
Preventive medicine, established patient, infant (under 1)
$3.0M
55K claims · 1.5%
$2.9M
45K claims
$65.03
$74.82
Preventive medicine, established patient, age 5-11
$2.9M
45K claims · 1.4%
$2.9M
38K claims
$76.60
$47.08
Ophthalmological exam, comprehensive, established patient
$2.9M
38K claims · 1.4%
$2.8M
59K claims
$47.83
$35.30
Subsequent hospital care, per day, high complexity
$2.8M
59K claims · 1.4%
$2.8M
103K claims
$26.77
$24.49
Therapeutic exercises, each 15 min
$2.8M
103K claims · 1.3%
$2.7M
29K claims
$94.12
$59.72
Ophthalmological exam, comprehensive, new patient
$2.7M
29K claims · 1.3%
$2.7M
119K claims
$22.53
$17.85
Immunization administration, first vaccine/toxoid, with counseling
$2.7M
119K claims · 1.3%
$2.7M
3K claims
$1,011.23
$1,482.45
Routine obstetric care, vaginal delivery, including postpartum
$2.7M
3K claims · 1.3%
$2.0M
23K claims
$88.37
$67.32
Initial hospital care, per day, high complexity
$2.0M
23K claims · 1.0%
$2.0M
17K claims
$118.27
$111.09
Office/outpatient visit, new patient, high complexity
$2.0M
17K claims · 0.9%
$1.9M
37K claims
$50.44
$49.45
Speech/hearing/language treatment
$1.9M
37K claims · 0.9%
$1.8M
54K claims
$33.58
$35.80
Surgical pathology, gross and microscopic examination
$1.8M
54K claims · 0.9%
$1.8M
24K claims
$76.01
$39.33
Screening mammography, bilateral, including CAD
$1.8M
24K claims · 0.9%
$1.7M
42K claims
$40.55
$33.11
Therapeutic activities, each 15 min
$1.7M
42K claims · 0.8%
Psychotherapy, 60 minutes
$1.6M
18K claims · 0.8%
$1.6M
22K claims
$70.13
$80.15
Preventive medicine, established patient, age 12-17
$1.6M
22K claims · 0.7%
$1.6M
44K claims
$35.43
$28.46
Streptococcus Group A detection, nucleic acid, amplified probe
$1.6M
44K claims · 0.7%
$1.5M
18K claims
$85.00
$63.08
Infectious disease detection (COVID-19)
$1.5M
18K claims · 0.7%
$1.5M
18K claims
$81.76
$76.06
Preventive medicine, established patient, age 40-64
$1.5M
18K claims · 0.7%
$1.5M
17K claims
$86.97
$65.76
CT abdomen and pelvis with contrast
$1.5M
17K claims · 0.7%
$1.5M
2K claims
$827.82
$470.36
Injection, onabotulinumtoxinA, 1 unit
$1.5M
2K claims · 0.7%