Robert Wood Johnson University Hospital, INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 125 procedure codes: G0378 at 9.2× median, 99285 at 4.7× 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 $915.29 per claim for G0378 (Hospital observation service, per hour) — 9.2× the national median of $99.39.
Bills $399.05 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 4.7× the national median of $85.65.
Bills $381.57 per claim for 99284 (Emergency dept visit, high complexity) — 5.5× the national median of $69.51.
Billing in the top 1% nationally for 2 procedure codes: 43239, 77334.
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 $198.3M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$198.3M
$198,255,360
Total Claims
2.7M
Beneficiaries
2.1M
1.3 claims/patient
Avg Cost/Claim
$73
#464 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Robert Wood Johnson University Hospital, INC is a General Acute Care Hospital provider based in New Brunswick, NJ. From the 2018–2024 period, this provider received $198.3M in Medicaid payments across 2.7M claims.
Why This Matters
This provider received $198.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,781 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 (G0378 (Hospital observation service, per hour)) accounts for 13% of total spending.
$25.3M
28K claims
$915.29
$99.39
Hospital observation service, per hour
$25.3M
28K claims · 12.8%
$15.2M
38K claims
$399.05
$85.65
Emergency dept visit, high/urgent complexity
$15.2M
38K claims · 7.7%
$14.9M
39K claims
$381.57
$69.51
Emergency dept visit, high complexity
$14.9M
39K claims · 7.5%
$14.4M
57K claims
$250.18
$42.48
Emergency dept visit, moderate complexity
$14.4M
57K claims · 7.2%
$8.5M
22K claims
$377.91
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$8.5M
22K claims · 4.3%
$7.8M
178K claims
$43.85
$1.68
Orthotic or prosthetic procedure, not otherwise classified
$7.8M
178K claims · 3.9%
$7.0M
2K claims
$3,987.44
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$7.0M
2K claims · 3.5%
Emergency dept visit, low complexity
$6.7M
35K claims · 3.4%
$5.4M
888 claims
$6,066.36
$5,391.55
Injection, pembrolizumab, 1 mg
$5.4M
888 claims · 2.7%
Upper GI endoscopy with biopsy
$4.2M
3K claims · 2.1%
$3.8M
766 claims · 1.9%
$2.7M
1K claims
$1,883.20
$763.43
Unlisted procedure, dentoalveolar structures
$2.7M
1K claims · 1.4%
$2.6M
27K claims · 1.3%
$2.3M
29K claims
$80.42
$14.92
Therapeutic/prophylactic/diagnostic IV push, each additional substance
$2.3M
29K claims · 1.2%
Comprehensive metabolic panel
$2.2M
113K claims · 1.1%
$2.1M
1K claims
$1,770.79
$331.68
Tonsillectomy and adenoidectomy, under age 12
$2.1M
1K claims · 1.0%
$1.8M
5K claims
$387.65
$260.56
Intensity modulated radiation treatment delivery, complex
$1.8M
5K claims · 0.9%
Colonoscopy with biopsy
$1.8M
2K claims · 0.9%
$1.7M
2K claims · 0.9%
$1.6M
8K claims
$215.79
$43.68
Chemotherapy infusion, each additional hour
$1.6M
8K claims · 0.8%
$1.6M
35K claims · 0.8%
$1.6M
15K claims
$106.21
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$1.6M
15K claims · 0.8%
Transfusion of whole blood
$1.4M
6K claims · 0.7%
$1.3M
991 claims · 0.7%
Tympanostomy, general anesthesia
$1.3M
1K claims · 0.6%
$1.2M
3K claims
$474.43
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.2M
3K claims · 0.6%
$1.2M
820 claims · 0.6%
$1.1M
19K claims · 0.5%
$1.1M
9K claims
$119.84
$65.76
CT abdomen and pelvis with contrast
$1.1M
9K claims · 0.5%
$1.0M
17K claims · 0.5%
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