Rector & Visitors of the University of Virginia
General Acute Care Hospital
Charlottesville, Virginia
NPI: 1780630608
Risk Tier
High
Total Paid
$500.5M
$500,546,324
Total Claims
7.2M
Beneficiaries
5.1M
Avg Cost/Claim
$69.70
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $202.61 per claim for 99214 (Office/outpatient visit, est. patient, mod-high complexity), which is 3.8× the national median of $53.41.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 262 procedure codes: 99214 at 3.8× median, 99213 at 5.4× median.
Advanced Detection Signals
Billing Velocity
3886.3 claims per working day — may exceed physically possible volume for a single provider.
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