IMPORTANT: Risk scores displayed here are statistical anomaly indicators, not evidence of fraud. High scores mean a provider's billing patterns deviate from peers — this requires official investigation to determine if actual fraud occurred.

This tool uses a 500-provider sample from the 227M-row DOGE HHS dataset. T-MSIS source data has known quality issues. See the Known Limitations section below for full details.

ANOMALY DEEP DIVE

This view identifies statistical outliers within each procedure code. For each CPT/HCPCS code, we estimate per-provider spending and flag those more than 2 standard deviations above the median. High outlier spending may indicate over-utilization, upcoding, or billing anomalies — but it can also reflect legitimate high-volume practices or specialized patient populations.

PROCEDURES ANALYZED

10

TOTAL SPENDING

$618.2B

OUTLIER PROVIDERS

309

OUTLIER SPENDING

$309.4B

50.1% of total

OUTLIER VS NORMAL SPENDING BY PROCEDURE

$0$50.0B$100.0B$150.0B$200.0BT1019992149921390834T2003971109083796372S5125H0015
Normal spending
Outlier spending (>2σ)