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

Park Nicollet Clinic

Obstetrics & Gynecology

St Louis Park, Minnesota

NPI: 1780621904

Risk Tier

High

Total Paid

$209.7M

$209,657,270

Total Claims

6.0M

Beneficiaries

5.3M

Avg Cost/Claim

$34.85

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (2)

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.

Advanced Detection Signals

Billing Velocity

3255.4 claims per working day — may exceed physically possible volume for a single provider.

CUSUM Change Point

Billing shifted 6.0x in 2018-11 — a statistically significant structural change in billing behavior was detected.

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