The General Hospital Corporation
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 96 procedure codes: 99211 at 8.8× median, 96361 at 10.1× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $113.78 per claim for 99211 (Office/outpatient visit, minimal complexity) — 8.8× the national median of $12.93.
Bills $392.07 per claim for 96361 (IV infusion, hydration, each additional hour) — 10.1× the national median of $38.92.
Bills $234.17 per claim for 96365 (IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour) — 4.3× the national median of $54.77.
Billing above the 90th percentile for 7 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $437.8M is at the 90th percentile among 156 General Acute Care Hospital providers.
Above 90th percentile for this specialty — higher spending than 140 of 156 peers
Total Paid
$437.8M
$437,796,181
Total Claims
10.3M
Beneficiaries
8.6M
1.2 claims/patient
Avg Cost/Claim
$43
#141 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
The General Hospital Corporation is a General Acute Care Hospital provider based in Boston, MA. From the 2018–2024 period, this provider received $437.8M in Medicaid payments across 10.3M claims.
Why This Matters
This provider received $437.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 54,724 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (99211 (Office/outpatient visit, minimal complexity)) accounts for 12% of total spending.
$52.2M
458K claims
$113.78
$12.93
Office/outpatient visit, minimal complexity
$52.2M
458K claims · 11.9%
$18.4M
47K claims
$392.07
$38.92
IV infusion, hydration, each additional hour
$18.4M
47K claims · 4.2%
$17.1M
263K claims
$64.99
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$17.1M
263K claims · 3.9%
$17.1M
83K claims
$204.73
$85.65
Emergency dept visit, high/urgent complexity
$17.1M
83K claims · 3.9%
$14.7M
89K claims
$165.58
$69.51
Emergency dept visit, high complexity
$14.7M
89K claims · 3.4%
$12.1M
62K claims
$195.00
$99.39
Hospital observation service, per hour
$12.1M
62K claims · 2.8%
$10.9M
46K claims
$234.17
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$10.9M
46K claims · 2.5%
$10.4M
239K claims
$43.33
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$10.4M
239K claims · 2.4%
$8.3M
58K claims
$143.50
$42.48
Emergency dept visit, moderate complexity
$8.3M
58K claims · 1.9%
$7.6M
2K claims
$3,834.70
$5,391.55
Injection, pembrolizumab, 1 mg
$7.6M
2K claims · 1.7%
$6.3M
40K claims
$155.72
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$6.3M
40K claims · 1.4%
$5.7M
297K claims
$19.34
$26.41
Hospital outpatient clinic visit
$5.7M
297K claims · 1.3%
Psychotherapy, 45 minutes
$5.7M
100K claims · 1.3%
Therapeutic exercises, each 15 min
$5.5M
110K claims · 1.3%
$5.2M
24K claims
$215.19
$260.56
Intensity modulated radiation treatment delivery, complex
$5.2M
24K claims · 1.2%
Upper GI endoscopy with biopsy
$5.0M
8K claims · 1.1%
$4.6M
82K claims
$56.03
$63.08
Infectious disease detection (COVID-19)
$4.6M
82K claims · 1.0%
$4.6M
19K claims
$235.99
$40.12
IV infusion, therapeutic/prophylactic/diagnostic, each additional hour
$4.6M
19K claims · 1.0%
$4.4M
3K claims · 1.0%
$4.0M
50K claims
$80.11
$74.09
Office/outpatient visit, high complexity
$4.0M
50K claims · 0.9%
$3.4M
30K claims
$114.26
$65.76
CT abdomen and pelvis with contrast
$3.4M
30K claims · 0.8%
$3.2M
3K claims · 0.7%
$3.1M
5K claims
$619.03
$255.17
Colonoscopy with polyp removal, snare technique
$3.1M
5K claims · 0.7%
CT head/brain without contrast
$3.0M
23K claims · 0.7%
$3.0M
36K claims
$84.63
$69.35
Preventive medicine, established patient, infant (under 1)
$3.0M
36K claims · 0.7%
$3.0M
1K claims
$2,349.57
$4,027.41
Injection, vedolizumab, one milligram
$3.0M
1K claims · 0.7%
$3.0M
5K claims
$574.79
$501.33
Crisis intervention mental health services, per diem
$3.0M
5K claims · 0.7%
$3.0M
42K claims
$70.88
$75.18
Preventive medicine, established patient, age 1-4
$3.0M
42K claims · 0.7%
$2.9M
47K claims
$62.50
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$2.9M
47K claims · 0.7%
$2.8M
19K claims
$148.88
$54.68
Echocardiography, transthoracic, complete, with Doppler
$2.8M
19K claims · 0.7%
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