Healthcare Fraud Detection Dataset is a realistic medical insurance claims dataset. It includes ICD-10 and CPT codes. The dataset is hosted on Kaggle.
Use Cases
- Detect fraudulent billing patterns based on ICD-10 diagnosis codes.
- Identify anomalous claim submissions based on CPT procedure codes.
- Train classification models for insurance fraud based on realistic claims data.
- Analyze relationships between diagnosis and procedure codes for fraud indicators.
- Benchmark fraud detection algorithms on a domain-specific dataset.
Strengths
- Dataset includes realistic medical insurance claims data.
- Contains standardized medical codes such as ICD-10 and CPT.
Limitations
- Row count is unknown, which may limit suitability assessment.
- Column-level documentation is absent; field semantics must be inferred after download.
- Last update date is unknown; freshness unverified.