Virtua - West Jersey Health System Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $473.05 per claim for 99284 (Emergency dept visit, high complexity), which is 6.8× the national median of $69.51.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 51 procedure codes: 99284 at 6.8× median, 99283 at 8.6× 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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
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 $473.05 per claim for 99284 (Emergency dept visit, high complexity) — 6.8× the national median of $69.51.
Bills $363.88 per claim for 99283 (Emergency dept visit, moderate complexity) — 8.6× the national median of $42.48.
Bills $619.35 per claim for G0378 (Hospital observation service, per hour) — 6.2× the national median of $99.39.
Billing in the top 1% nationally for 2 procedure codes: 99284, 43239.
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 $255.7M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$255.7M
$255,730,619
Total Claims
3.4M
Beneficiaries
2.7M
1.3 claims/patient
Avg Cost/Claim
$76
#322 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Virtua - West Jersey Health System Inc. is a General Acute Care Hospital provider based in Voorhees, NJ. From the 2018–2024 period, this provider received $255.7M in Medicaid payments across 3.4M claims.
Why This Matters
This provider received $255.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 31,966 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 (99284 (Emergency dept visit, high complexity)) accounts for 29% of total spending.
$74.9M
158K claims
$473.05
$69.51
Emergency dept visit, high complexity
$74.9M
158K claims · 29.3%
$46.2M
127K claims
$363.88
$42.48
Emergency dept visit, moderate complexity
$46.2M
127K claims · 18.1%
$26.8M
90K claims
$297.88
$148.53
Mental health partial hospitalization, treatment, per hour
$26.8M
90K claims · 10.5%
$13.8M
22K claims
$619.35
$99.39
Hospital observation service, per hour
$13.8M
22K claims · 5.4%
$9.4M
27K claims
$355.29
$85.65
Emergency dept visit, high/urgent complexity
$9.4M
27K claims · 3.7%
$8.9M
40K claims
$223.48
$164.22
Ambulance, ALS emergency transport Level 1
$8.9M
40K claims · 3.5%
Emergency dept visit, low complexity
$8.0M
43K claims · 3.1%
CT abdomen and pelvis with contrast
$2.7M
14K claims · 1.1%
Ambulance, specialty care transport
$2.5M
6K claims · 1.0%
$2.1M
62K claims
$34.46
$16.79
Manual therapy techniques, per 15 minutes
$2.1M
62K claims · 0.8%
$2.1M
144K claims
$14.88
$24.49
Therapeutic exercises, each 15 min
$2.1M
144K claims · 0.8%
$2.1M
11K claims
$195.66
$138.19
Ambulance, BLS emergency transport
$2.1M
11K claims · 0.8%
Fetal non-stress test
$1.8M
13K claims · 0.7%
$1.7M
21K claims · 0.7%
$1.6M
26K claims
$63.08
$77.33
Family psychotherapy with patient, 50 min
$1.6M
26K claims · 0.6%
$1.6M
2K claims · 0.6%
$1.5M
9K claims
$157.44
$60.19
CT abdomen and pelvis without contrast
$1.5M
9K claims · 0.6%
$1.5M
6K claims
$261.11
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.5M
6K claims · 0.6%
Ground mileage, per statute mile
$1.4M
67K claims · 0.5%
$1.2M
14K claims · 0.5%
CT head/brain without contrast
$1.2M
18K claims · 0.5%
$1.2M
37K claims
$32.75
$33.11
Therapeutic activities, each 15 min
$1.2M
37K claims · 0.5%
Upper GI endoscopy with biopsy
$1.2M
990 claims · 0.4%
$1.1M
65K claims
$17.68
$9.56
Therapeutic injection, subcutaneous/intramuscular
$1.1M
65K claims · 0.4%
$1.1M
16K claims
$69.52
$35.80
Surgical pathology, gross and microscopic examination
$1.1M
16K claims · 0.4%
$1.1M
4K claims
$303.12
$106.79
Ultrasound, pregnant uterus, detailed, single fetus
$1.1M
4K claims · 0.4%
Psychiatric diagnostic evaluation
$1.1M
6K claims · 0.4%
Ultrasound, pregnant uterus, limited
$1.0M
8K claims · 0.4%
Psychotherapy, 30 minutes
$1.0M
14K claims · 0.4%
Chest X-ray, 2 views
$998K
28K claims · 0.4%
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