Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Newark Beth Israel Medical Center INC

General Acute Care Hospital·Newark, NJ·NPI: 1215027966SharePrint Report
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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:

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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.

Risk Assessment

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Bills $414.46 per claim for 99283 (Emergency dept visit, moderate complexity) — 9.8× the national median of $42.48.

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Bills $1,108.60 per claim for G0378 (Hospital observation service, per hour) — 11.2× the national median of $99.39.

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Bills $490.49 per claim for 99284 (Emergency dept visit, high complexity) — 7.1× the national median of $69.51.

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Billing in the top 1% nationally for 15 procedure codes: 99283, 99284, 93306.

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

P25MedianP75P90

This provider's total spending of $380.2M is at the 75th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-01→2024-12(84 months)
Sharp billing drop in final month

Total Paid

$380.2M

$380,157,758

Total Claims

3.3M

Beneficiaries

2.8M

1.2 claims/patient

Avg Cost/Claim

$114

#170 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Newark Beth Israel Medical Center INC is a General Acute Care Hospital provider based in Newark, NJ. From the 2018–2024 period, this provider received $380.2M in Medicaid payments across 3.3M claims.

Why This Matters

This provider received $380.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 47,519 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 2% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$56.6M
-1%
2019
$56.3M
-28%
2020
$40.7M
+24%
2021
$50.6M
+14%
2022
$57.5M
+10%
2023
$63.1M
-12%
2024
$55.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 15% of total spending.

99283Top 1%

Emergency dept visit, moderate complexity

$56.3M

136K claims · 14.8%

Your Cost: $414.46/claim|Median: $42.48
9.8× median
G0378Top 5%

Hospital observation service, per hour

$45.0M

41K claims · 11.8%

Your Cost: $1,108.60/claim|Median: $99.39
11.2× median
99284Top 1%

Emergency dept visit, high complexity

$38.5M

78K claims · 10.1%

Your Cost: $490.49/claim|Median: $69.51
7.1× median
99285Top 5%

Emergency dept visit, high/urgent complexity

$24.9M

54K claims · 6.6%

Your Cost: $461.37/claim|Median: $85.65
5.4× median
93306Top 1%

Echocardiography, transthoracic, complete, with Doppler

$18.9M

15K claims · 5.0%

Your Cost: $1,254.40/claim|Median: $54.68
22.9× median
OP250Top 1%

Orthotic or prosthetic procedure, not otherwise classified

$10.0M

222K claims · 2.6%

Your Cost: $44.87/claim|Median: $1.68
26.7× median
99282Top 5%

Emergency dept visit, low complexity

$9.7M

35K claims · 2.5%

Your Cost: $274.76/claim|Median: $37.72
7.3× median
93303Top 1%

Echocardiography, transthoracic, limited

$9.5M

8K claims · 2.5%

Your Cost: $1,136.06/claim|Median: $112.83
10.1× median
43239Top 1%

Upper GI endoscopy with biopsy

$6.9M

4K claims · 1.8%

Your Cost: $1,844.97/claim|Median: $151.68
12.2× median
93320Top 1%

$6.7M

10K claims · 1.8%

Your Cost: $686.88/claim|Median: $28.68
23.9× median
93325Top 1%

$6.3M

13K claims · 1.7%

Your Cost: $501.10/claim|Median: $14.61
34.3× median
S9480Top 10%

Intensive outpatient psychiatric services, per diem

$6.0M

8K claims · 1.6%

Your Cost: $725.04/claim|Median: $135.70
5.3× median
95810Top 1%

Polysomnography, sleep study, 6+ hours

$5.4M

2K claims · 1.4%

Your Cost: $2,883.15/claim|Median: $233.73
12.3× median
H0035Normal range

Mental health partial hospitalization, treatment, per hour

$4.0M

18K claims · 1.1%

Your Cost: $219.89/claim|Median: $148.53
1.5× median
93005Top 10%

Electrocardiogram, tracing only, without interpretation

$3.3M

55K claims · 0.9%

Your Cost: $61.14/claim|Median: $7.50
8.2× median
OP370Normal range

$3.1M

28K claims · 0.8%

Your Cost: $113.09/claim|Median: $82.47
1.4× median
96413Top 5%

Chemotherapy administration, IV infusion, up to 1 hour

$3.1M

7K claims · 0.8%

Your Cost: $447.11/claim|Median: $75.28
5.9× median
76818Top 1%

$3.0M

12K claims · 0.8%

Your Cost: $247.82/claim|Median: $68.15
3.6× median
76819Top 1%

Fetal biophysical profile with non-stress test

$2.9M

14K claims · 0.8%

Your Cost: $214.47/claim|Median: $49.45
4.3× median
11043Top 1%

$2.9M

4K claims · 0.8%

Your Cost: $810.65/claim|Median: $62.99
12.9× median
80053Top 10%

Comprehensive metabolic panel

$2.6M

117K claims · 0.7%

Your Cost: $22.58/claim|Median: $7.24
3.1× median
41899Top 10%

Unlisted procedure, dentoalveolar structures

$2.4M

1K claims · 0.6%

Your Cost: $2,197.68/claim|Median: $763.43
2.9× median
45378Top 1%

Colonoscopy, diagnostic

$1.9M

1K claims · 0.5%

Your Cost: $1,613.24/claim|Median: $225.49
7.2× median
96375Top 10%

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$1.9M

30K claims · 0.5%

Your Cost: $64.77/claim|Median: $14.92
4.3× median
95813Top 5%

$1.9M

3K claims · 0.5%

Your Cost: $628.94/claim|Median: $121.48
5.2× median
36430Top 1%

Transfusion of whole blood

$1.8M

3K claims · 0.5%

Your Cost: $567.56/claim|Median: $111.66
5.1× median
99211Top 10%

Office/outpatient visit, minimal complexity

$1.8M

43K claims · 0.5%

Your Cost: $42.71/claim|Median: $12.93
3.3× median
76816Top 10%

Ultrasound, pregnant uterus, follow-up

$1.7M

17K claims · 0.5%

Your Cost: $102.87/claim|Median: $58.55
1.8× median
71046Top 5%

Chest X-ray, 2 views

$1.7M

27K claims · 0.5%

Your Cost: $64.04/claim|Median: $8.92
7.2× median
76817Top 1%

Ultrasound, pregnant uterus, transvaginal

$1.7M

10K claims · 0.4%

Your Cost: $164.51/claim|Median: $47.65
3.5× median

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