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

Capitol County Children's Collaborative

Exclusive Provider Organization·Hamilton, NJ·NPI: 1942350020SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Single-Code

Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Total Paid

$63.1M

$63,083,828

Total Claims

68K

Beneficiaries

67K

1.0 claims/patient

Avg Cost/Claim

$934

🔍 Analysis

Provider Overview

Capitol County Children's Collaborative is a Exclusive Provider Organization provider based in Hamilton, NJ. From the 2018–2024 period, this provider received $63.1M in Medicaid payments across 68K claims.

Important Context

  • ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.

Why This Matters

At $63.1M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.

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