University Hospital
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 225 procedure codes: 99283 at 10.4× median, G0378 at 13.6× 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.
Risk Assessment
Bills $443.86 per claim for 99283 (Emergency dept visit, moderate complexity) — 10.4× the national median of $42.48.
Bills $1,354.51 per claim for G0378 (Hospital observation service, per hour) — 13.6× the national median of $99.39.
Bills $510.75 per claim for 99284 (Emergency dept visit, high complexity) — 7.3× the national median of $69.51.
Billing in the top 1% nationally for 4 procedure codes: 99283, 99284, 99285.
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 $362.9M is at the 75th percentile among 156 General Acute Care Hospital providers.
Total Paid
$362.9M
$362,912,757
Total Claims
4.7M
Beneficiaries
4.0M
1.2 claims/patient
Avg Cost/Claim
$77
#186 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
University Hospital is a General Acute Care Hospital provider based in Newark, NJ. From the 2018–2024 period, this provider received $362.9M in Medicaid payments across 4.7M claims.
Why This Matters
This provider received $362.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 45,364 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 (99283 (Emergency dept visit, moderate complexity)) accounts for 12% of total spending.
$42.8M
96K claims
$443.86
$42.48
Emergency dept visit, moderate complexity
$42.8M
96K claims · 11.8%
$38.0M
28K claims
$1,354.51
$99.39
Hospital observation service, per hour
$38.0M
28K claims · 10.5%
$35.0M
69K claims
$510.75
$69.51
Emergency dept visit, high complexity
$35.0M
69K claims · 9.7%
$25.2M
137K claims
$183.92
$138.19
Ambulance, BLS emergency transport
$25.2M
137K claims · 7.0%
$23.0M
34K claims
$680.20
$85.65
Emergency dept visit, high/urgent complexity
$23.0M
34K claims · 6.3%
$22.7M
232K claims
$97.80
$25.06
Office/outpatient visit, low complexity
$22.7M
232K claims · 6.3%
$11.3M
31K claims
$366.94
$164.22
Ambulance, ALS emergency transport Level 1
$11.3M
31K claims · 3.1%
$7.0M
3K claims
$2,487.36
$763.43
Unlisted procedure, dentoalveolar structures
$7.0M
3K claims · 1.9%
$6.9M
23K claims · 1.9%
$6.5M
41K claims · 1.8%
$5.9M
24K claims · 1.6%
CT head/brain without contrast
$4.2M
18K claims · 1.2%
Upper GI endoscopy with biopsy
$3.8M
3K claims · 1.1%
$3.0M
3K claims
$1,152.27
$133.68
MRI brain without contrast, then with contrast
$3.0M
3K claims · 0.8%
$2.8M
179K claims · 0.8%
$2.6M
7K claims
$345.88
$54.68
Echocardiography, transthoracic, complete, with Doppler
$2.6M
7K claims · 0.7%
Emergency dept visit, low complexity
$2.5M
13K claims · 0.7%
$2.4M
62K claims
$38.64
$7.50
Electrocardiogram, tracing only, without interpretation
$2.4M
62K claims · 0.7%
$2.4M
25K claims · 0.7%
$2.3M
32K claims
$72.01
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$2.3M
32K claims · 0.6%
Critical care, first 30-74 minutes
$2.2M
3K claims · 0.6%
CT abdomen and pelvis with contrast
$2.2M
13K claims · 0.6%
$2.1M
3K claims
$657.05
$112.83
Echocardiography, transthoracic, limited
$2.1M
3K claims · 0.6%
$2.0M
53K claims
$37.98
$34.62
COVID-19 lab test, non-CDC, nucleic acid
$2.0M
53K claims · 0.6%
$1.9M
8K claims
$248.01
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$1.9M
8K claims · 0.5%
$1.9M
341 claims
$5,657.32
$5,391.55
Injection, pembrolizumab, 1 mg
$1.9M
341 claims · 0.5%
$1.9M
20K claims · 0.5%
$1.9M
27K claims
$70.25
$14.92
Therapeutic/prophylactic/diagnostic IV push, each additional substance
$1.9M
27K claims · 0.5%
$1.8M
2K claims · 0.5%
$1.8M
1K claims
$1,322.91
$123.40
Anchor or screw for tissue to bone fixation
$1.8M
1K claims · 0.5%
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