Skip to main content

Advertisement

Table 4 Summary of Medicare datasets

From: The effects of class rarity on the evaluation of supervised healthcare fraud detection models

Year Part B Part D DMEPOS Combined
Fraud %Fraud Fraud %Fraud Fraud %Fraud Fraud %Fraud
(a) By year
2012 546 0.062
2013 403 0.044 465 0.069 323 0.110 229 0.090
2014 285 0.030 329 0.047 193 0.068 154 0.061
2015 175 0.018 224 0.031 119 0.041 90 0.035
2016 99 0.010 135 0.018 75 0.026 55 0.021
PCC Part B Part D DMEPOS Combined
Fraud %Fraud Fraud %Fraud Fraud %Fraud Fraud %Fraud
(b) Class imbalance and rarity
All 1409 0.038 1018 0.048 635 0.074 437 0.062
1000 1000 0.027
400 400 0.011 400 0.019 400 0.046
200 200 0.005 200 0.010 200 0.023 200 0.026
100 100 0.005 100 0.012 100 0.013