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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. States
  3. Pennsylvania
  4. Fraud Risk

Medicare Fraud Risk in Pennsylvania

16 flagged providers identified through statistical analysis of billing anomalies.

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Flagged Providers

16

Average Risk Score

72/100

State Markup Ratio

3.5x

National avg: 3.8x

Total Medicare Payments

$34.5B

🔥 Fraud Hotspots in Pennsylvania

Cities with the most flagged providers based on billing anomaly analysis.

Pittsburgh2 flagged providers
Kingston2 flagged providers
Dunmore2 flagged providers
Upper Chichester1 flagged provider
Malvern1 flagged provider
Pottstown1 flagged provider
Allentown1 flagged provider
Erie1 flagged provider
Blue Bell1 flagged provider
Drexel Hill1 flagged provider

Flagged Providers in Pennsylvania

ProviderSpecialtyCityRisk ScoreTotal PaymentsMarkup
Pentec Health IncPharmacyUpper Chichester80$4.4M6.5x
Cardionet, LlcIndependent Diagnostic Testing Facility (IDTF)Malvern79$11.0M26.4x
Quest Diagnostics Of Pennsylvania, Inc.Clinical LaboratoryPittsburgh78$11.3M8.9x
Scot ParisGeneral SurgeryPottstown77$1.0M48.1x
Health Network Laboratories, LlcClinical LaboratoryAllentown75$12.5M6.7x
Quest Diagnostics Venture LlcClinical LaboratoryPittsburgh75$7.2M8.8x
Associated Clinical LaboratoriesClinical LaboratoryErie72$3.8M8.5x
Silverpath, Inc.Clinical LaboratoryBlue Bell70$41.9M1.2x
Bruce SaidmanMedical OncologyKingston69$3.4M14.5x
Barry JacobsonObstetrics & GynecologyDrexel Hill69$3.0M3.1x
David GreenwaldMedical OncologyKingston69$2.7M14.9x
Jennifer WeedNurse PractitionerAbington67$413.1K49.3x
Carmen ChengPhysician AssistantHorsham67$370.2K46.7x
Padmaja BojanapallyHematology-OncologyDunmore66$2.0M19.9x
John DevlinHematologyBryn Mawr66$2.0M15.9x
Carl BarsigianHematology-OncologyDunmore66$1.4M20.9x

Compared to Neighboring States

StateFlagged ProvidersMarkup Ratio
Pennsylvania (this state)163.5x
Delaware13.4x
Maryland103.3x
New Jersey153.9x
New York393.8x
Ohio53.7x
West Virginia03.6x

⚠️ Disclaimer: Being flagged does not imply fraud. These providers were identified through statistical analysis of billing patterns that deviate significantly from peers. Unusual billing may have legitimate explanations. This data is provided for transparency and public accountability purposes only.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • OpenMedicare Statistical Anomaly Detection

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.