Pennsylvania's 30,709 Medicaid providers billed $27.88B between 2018 and 2024. The most-billed code is W1793, accounting for $2.19B in payments. Philadelphia is the largest Medicaid billing hub in the state. 20 providers in PA appear on the OIG exclusion list.
| Code | Description | Total Paid |
|---|---|---|
| W1793 | State-specific procedure code | $2.19B |
| T1015 | Clinic visit/encounter, all-inclusive | $2.04B |
| H2036 | Alcohol and/or other drug treatment program, per diem | $1.02B |
PHILADELPHIA ($5.58B) PITTSBURGH ($2.43B) HARRISBURG ($638.34M) ALLENTOWN ($600.01M) SCRANTON ($542.97M) ERIE ($537.93M) READING ($491.30M) LANCASTER ($452.41M) BETHLEHEM ($384.63M) MONROEVILLE ($370.70M) WEST HAZLETON ($326.39M) YORK ($324.11M) WARMINSTER ($321.01M) BENSALEM ($301.59M) KING OF PRUSSIA ($297.97M) WILKES BARRE ($286.95M) JOHNSTOWN ($257.01M) WILKINSBURG ($253.69M) CHAMBERSBURG ($247.99M) GREENSBURG ($235.51M) BALA CYNWYD ($235.35M) DANVILLE ($229.90M) LEBANON ($220.37M) UNIONTOWN ($220.36M) NEW CASTLE ($207.06M) PHILA ($205.58M) WILLIAMSPORT ($200.73M) CORAOPOLIS ($191.70M) ALTOONA ($187.07M) MALVERN ($185.06M) UPPER DARBY ($170.88M) ALLENWOOD ($145.83M) EAST STROUDSBURG ($145.16M) FEASTERVILLE TREVOSE ($143.99M) CHESTER ($142.74M) HERSHEY ($141.36M) WASHINGTON ($141.18M) BRYN MAWR ($137.58M) WARRENDALE ($135.80M) STATE COLLEGE ($129.96M) BROOMALL ($129.78M) BEAVER ($129.70M) SHARON ($129.00M) BUTLER ($127.53M) DU BOIS ($125.87M) WEST CHESTER ($124.17M) EAGLEVILLE ($120.49M) JENKINTOWN ($119.04M) HUNTINGDON VALLEY ($112.98M) POTTSVILLE ($112.96M)
Automated signals based on claims-per-beneficiary ratios, single-code concentration, and OIG exclusion status. These are statistical outliers — not evidence of fraud. Learn more
| # | Provider | Total Paid | Flags |
|---|---|---|---|
| 1 | ZOLL SERVICES LLC | $503.99M | single-code billing |
| 2 | PATRIOT HOME CARE, INC | $135.81M | single-code billing |
| 3 | MORAVIA HEALTH NETWORK, LLC | $55.73M | single-code billing |
| 4 | 365 HEALTH SERVICES LLC | $46.12M | single-code billing |
| 5 | ALL AMERICAN HOME CARE LLC | $44.90M | single-code billing |
| 6 | VITAL SUPPORT HOME HEALTH CARE AGENCY, INC. | $44.28M | single-code billing |
| 7 | DAILY DOVE CARE, LLC | $41.99M | single-code billing |
| 8 | PEERSTAR, LLC | $40.64M | single-code billing |
| 9 | MELMARK, INC. | $34.96M | single-code billing |
| 10 | CARE AND HELP HOME CARE LLC | $31.12M | single-code billing |
| 11 | THE DEVEREUX FOUNDATION | $29.67M | single-code billing |
| 12 | BAYADA HOME HEALTH CARE, INC. | $27.89M | single-code billing |
| 13 | PMHCC CTT INC | $27.49M | single-code billing |
| 14 | PHILADELPHIA HOME HEALTH SERVICES, LLC | $25.65M | single-code billing |
| 15 | AGING WITH COMFORT | $25.30M | single-code billing |
| 16 | BLESSINGS4EVER HOME CARE AGENCY | $25.11M | single-code billing |
| 17 | COLUMBUS MEDICAL SERVICES, LLC | $25.03M | single-code billing |
| 18 | TEMPLE UNIVERSITY HOSPITAL, INC - PSYCH UNIT | $22.27M | single-code billing |
| 19 | BAYADA HOME HEALTH CARE, INC. | $21.69M | single-code billing |
| 20 | ELWYN OF PENNSYLVANIA AND DELAWARE | $21.09M | single-code billing |
| 21 | ELDER RESOURCE MANAGEMENT, INC | $20.87M | single-code billing |
| 22 | DAVETTA CARE LLC | $20.21M | single-code billing |
| 23 | ACCESS HOME CARE, INC. | $19.41M | single-code billing |
| 24 | PHILADELPHIA HOME CARE AGENCY, INC | $18.82M | single-code billing |
| 25 | YAPA APARTMENT LIVING PROGRAM, INC | $18.54M | single-code billing |
| # | Provider | City | Claims | Total Paid |
|---|---|---|---|---|
| 1 | ZOLL SERVICES LLC | PITTSBURGH | 477,988 | $503.99M |
| 2 | COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF EDUCATION | WEST HAZLETON | 12,967,883 | $326.02M |
| 3 | EXCEL COPMANION CARE INC | WARMINSTER | 1,727,955 | $308.39M |
| 4 | CHILDRENS HOSPITAL OF PHILADELPHIA | PHILADELPHIA | 1,676,908 | $286.88M |
| 5 | PROCARE PHARMACY DIRECT, LLC. | MONROEVILLE | 82,891 | $227.31M |
| 6 | NORTHEAST PENNSYLVANIA CENTER FOR INDEPENDENT LIVING | SCRANTON | 3,226,844 | $227.19M |
| 7 | TOBII DYNAVOX LLC | CORAOPOLIS | 63,568 | $182.09M |
| 8 | WHITE DEER RUN, LLC | ALLENWOOD | 463,838 | $145.83M |
| 9 | PATRIOT HOME CARE, INC | PHILADELPHIA | 823,581 | $135.81M |
| 10 | QUEST DIAGNOSTICS OF PENNSYLVANIA, INC. | PITTSBURGH | 11,245,781 | $132.39M |
| 11 | ACCREDO HEALTH GROUP INC | WARRENDALE | 150,809 | $130.92M |
| 12 | SERVICE ACCESS AND MANAGEMENT INC | READING | 1,377,142 | $128.95M |
| 13 | PYRAMID HEALTH CARE INC. | WILKINSBURG | 422,669 | $128.75M |
| 14 | ACT HOME HEALTH SERVICES, INC | PHILADELPHIA | 174,089 | $125.95M |
| 15 | UPMC PRESBYTERIAN SHADYSIDE | PITTSBURGH | 1,693,653 | $125.54M |
| 16 | WESLEY FAMILY SERVICES | WILKINSBURG | 652,317 | $123.40M |
| 17 | TEMPLE UNIVERSITY HOSPITAL, INC | PHILADELPHIA | 1,303,178 | $116.55M |
| 18 | CITY OF PHILADELPHIA | PHILADELPHIA | 555,084 | $108.09M |
| 19 | THE WRIGHT CENTER MEDICAL GROUP | SCRANTON | 1,249,699 | $106.10M |
| 20 | EPIC HEALTH SERVICES (PA), LLC | BALA CYNWYD | 298,568 | $104.43M |
| 21 | YOUTH ADVOCATE PROGRAMS, INC. | HARRISBURG | 793,885 | $101.00M |
| 22 | QUEST DIAGNOSTICS VENTURE LLC | PITTSBURGH | 3,644,771 | $96.03M |
| 23 | ADAPTHEALTH PATIENT CARE SOLUTIONS LLC | BEAVER | 1,877,874 | $93.56M |
| 24 | BAYADA HOME HEALTH CARE, INC. | MONROEVILLE | 187,522 | $92.03M |
| 25 | MALVERN INSTITUTE FOR PSYCHIATRIC AND ALCOHOLIC STUDIES, INC. | MALVERN | 37,992 | $91.67M |
| 26 | EAGLEVILLE HOSPITAL | EAGLEVILLE | 224,122 | $89.89M |
| 27 | PYRAMID HEALTHCARE | BELLEVILLE | 321,797 | $87.33M |
| 28 | ATLANTIC DIAGNOSTIC LABORATORIES, LLC. | BENSALEM | 1,912,901 | $87.05M |
| 29 | BAYADA HOME HEALTH CARE, INC. | BLAIRSVILLE | 209,388 | $85.14M |
| 30 | TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PHILADELPHIA | 1,205,865 | $84.02M |
| 31 | UPMC CHILDREN'S HOSPITAL OF PITTSBURGH | PITTSBURGH | 1,042,961 | $83.00M |
| 32 | GUTHRIE MEDICAL GROUP, P.C. | SAYRE | 1,899,181 | $82.19M |
| 33 | ALBERT EINSTEIN MEDICAL CENTER | PHILA | 1,034,137 | $81.13M |
| 34 | INTERIM HEALTHCARE OF PITTSBURGH, INC. | PITTSBURGH | 184,620 | $79.99M |
| 35 | PENNSYLVANIA COUNSELING SERVICES INC. | LEBANON | 775,552 | $79.98M |
| 36 | MEDCARE EQUIPMENT COMPANY, LLC | EXPORT | 1,453,390 | $79.35M |
| 37 | THE MILTON S HERSHEY MEDICAL CENTER | HERSHEY | 1,567,535 | $78.95M |
| 38 | THE PROMPTCARE COMPANIES, INC. | KING OF PRUSSIA | 456,444 | $78.47M |
| 39 | KALEIDOSCOPE FAMILY SOLUTIONS, INC. | BRYN MAWR | 519,424 | $78.19M |
| 40 | MATRIX BEHAVIOR SOLUTIONS, LLC | EAST STROUDSBURG | 342,630 | $75.61M |
| 41 | MERCY LIFE CENTER CORPORATION | PITTSBURGH | 486,547 | $75.48M |
| 42 | BRETT DINOVI & ASSOCIATES PA LLC | BENSALEM | 181,564 | $74.79M |
| 43 | GEISINGER CLINIC | DANVILLE | 1,713,968 | $74.54M |
| 44 | NURSING HOME CARE MANAGEMENT INC., | PHILADELPHIA | 477,147 | $74.23M |
| 45 | BEHAVIOR INTERVENTIONS, INC | KING OF PRUSSIA | 385,107 | $73.77M |
| 46 | ARS TREATMENT CENTERS, P.C. | UNIONTOWN | 743,115 | $73.26M |
| 47 | CORECARE BEHAVIORAL HEALTH MANAGEMENT, INC. | PHILADELPHIA | 282,909 | $73.17M |
| 48 | CONTINUUM, LLC | PHILADELPHIA | 1,020,191 | $72.13M |
| 49 | OPEN SYSTEMS HEALTHCARE, INC. | PHILADELPHIA | 466,429 | $72.12M |
| 50 | STC OPCO LLC | PHILADELPHIA | 455,601 | $69.20M |
| 51 | MERCY LIFE CENTER CORPORATION | PITTSBURGH | 491,224 | $68.49M |
| 52 | MEDSCOPE AMERICA LLC | PHILADELPHIA | 2,684,056 | $66.45M |
| 53 | VISITING NURSE GROUP, INC | PHILADELPHIA | 95,477 | $66.34M |
| 54 | KINGS HOME HEALTHCARE INC. | HARRISBURG | 299,520 | $64.98M |
| 55 | PANTHERX SPECIALTY LLC | PITTSBURGH | 19,626 | $64.93M |
| 56 | LEHIGH VALLEY HOSPITAL | ALLENTOWN | 1,163,602 | $64.40M |
| 57 | T.W. PONESSA & ASSOCIATES COUNSELING SERVICES, INC. | LANCASTER | 675,210 | $63.64M |
| 58 | CARDIONET, LLC | MALVERN | 405,227 | $63.17M |
| 59 | CHILDREN'S CRISIS TREATMENT CENTER | PHILADELPHIA | 579,266 | $61.39M |
| 60 | APEX HUMAN SERVICES, LLC | SECANE | 47,943 | $59.73M |
| 61 | READING HOSPITAL | WEST READING | 1,585,847 | $58.34M |
| 62 | PRIMARY HEALTH NETWORK | SHARON | 396,925 | $57.95M |
| 63 | CHILDRENS BEHAVIORAL HEALTH, LLC | JOHNSTOWN | 351,068 | $57.23M |
| 64 | MORAVIA HEALTH NETWORK, LLC | PHILADELPHIA | 325,113 | $55.73M |
| 65 | AMERIBEST HOME CARE, LLC | PHILADELPHIA | 335,047 | $55.28M |
| 66 | MAXIM HEALTHCARE SERVICES, INC. | PITTSBURGH | 81,272 | $54.90M |
| 67 | BGI OF BRANDYWINE, LLC | KENNETT SQUARE | 187,780 | $54.55M |
| 68 | BAYADA HOME HEALTH CARE, INC. | STATE COLLEGE | 106,002 | $51.69M |
| 69 | AURORA HOME CARE, INC | FEASTERVILLE TREVOSE | 274,968 | $51.68M |
| 70 | UHS RECOVERY FOUNDATION INC | CHESTER | 167,783 | $51.65M |
| 71 | QUALITY PROGRESSIONS | PHILADELPHIA | 564,676 | $50.64M |
| 72 | GWR MEDICAL, INC. | CHADDS FORD | 9,740 | $50.10M |
| 73 | MEDICAL EXPRESS DEPOT, INC. | PITTSBURGH | 219,383 | $49.65M |
| 74 | COMMUNITY SERVICES GROUP, INC. | MOUNTVILLE | 502,914 | $48.91M |
| 75 | FAMILYLINKS, INC | PITTSBURGH | 601,663 | $48.53M |
| 76 | DRUGSCAN, INC. | HORSHAM | 1,963,232 | $48.28M |
| 77 | PATHWAYS HUMAN SERVICES OF PENNSYLVANIA, LLC | GREENSBURG | 443,447 | $47.89M |
| 78 | SALISBURY BEHAVIORAL HEALTH, LLC. | GLENSIDE | 263,978 | $47.79M |
| 79 | CENTER FOR EMERGENCY MEDICINE OF WESTERN PENNSYLVANIA | WEST MIFFLIN | 31,699 | $47.75M |
| 80 | BAYADA HOME HEALTH CARE, INC. | WILKES-BARRE | 101,523 | $47.57M |
| 81 | HEALTH NETWORK LABORATORIES, LLC | ALLENTOWN | 2,167,394 | $47.53M |
| 82 | BRIGHT MEDICAL TECHNOLOGY INC | PHILADELPHIA | 753,436 | $47.48M |
| 83 | WHITE DEER RUN, LLC | WILLIAMSBURG | 167,885 | $47.37M |
| 84 | BRIGHT BEGINNINGS THERAPEUTIC SERVICES, LLC | CARBONDALE | 208,033 | $46.76M |
| 85 | EFCC ACQUISITION CORP | PITTSBURGH | 173,567 | $46.59M |
| 86 | PRINCIPLE LABS LLC | BETHLEHEM | 664,513 | $46.31M |
| 87 | 365 HEALTH SERVICES LLC | PHILADELPHIA | 247,102 | $46.12M |
| 88 | STAR COMMUNITY HEALTH, INC | BETHLEHEM | 643,815 | $45.57M |
| 89 | ALL AMERICAN HOME CARE LLC | PHILADELPHIA | 293,793 | $44.90M |
| 90 | NATIONAL MENTOR HEALTHCARE, LLC | BROOMALL | 244,392 | $44.63M |
| 91 | VITAL SUPPORT HOME HEALTH CARE AGENCY, INC. | PHILADELPHIA | 317,428 | $44.28M |
| 92 | BERKS COUNSELING CENTER, INC. | READING | 215,095 | $43.90M |
| 93 | ERIE COUNTY CARE MANAGEMENT | ERIE | 459,867 | $43.41M |
| 94 | GATEWAY REHABILITATION CENTER | MT PLEASANT | 128,874 | $43.30M |
| 95 | UPMC MAGEE-WOMENS HOSPITAL | PITTSBURGH | 1,244,546 | $43.08M |
| 96 | DAILY DOVE CARE, LLC | PHILADELPHIA | 217,700 | $41.99M |
| 97 | PROSPECT CCMC, LLC | CHESTER | 310,908 | $40.89M |
| 98 | ESPERANZA HEALTH CENTER, INC. | PHILADELPHIA | 454,964 | $40.83M |
| 99 | YORK HOSPITAL | YORK | 1,187,279 | $40.75M |
| 100 | CHILDREN'S DENTAL HEALTH ASSOCIATES | CHADDS FORD | 1,149,448 | $40.64M |