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

Suny Health Science Center at Syracuse

General Acute Care Hospital·Syracuse, NY·NPI: 1578554630SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

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

Change PointBilling shifted 49.1x in 2019-09

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $182.62 per claim for 99283 (Emergency dept visit, moderate complexity) — 4.3× the national median of $42.48.

Bills $164.28 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity) — 4.3× the national median of $37.81.

Bills $173.42 per claim for 99214 (Office/outpatient visit, est. patient, mod-high complexity) — 3.3× the national median of $53.41.

Billing in the top 1% nationally for 4 procedure codes: 99213, 97110, 93976.

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 $179.8M is at the 50th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-012024-12(84 months)
Sharp billing drop in final month

Total Paid

$179.8M

$179,830,985

Total Claims

3.3M

Beneficiaries

2.9M

1.1 claims/patient

Avg Cost/Claim

$55

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

🔍 Analysis

Provider Overview

Suny Health Science Center at Syracuse is a General Acute Care Hospital provider based in Syracuse, NY. From the 2018–2024 period, this provider received $179.8M in Medicaid payments across 3.3M claims.

Why This Matters

This provider received $179.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 22,478 Medicaid beneficiaries for a full year at average per-enrollee costs.

12993% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$260K
+3458%
2019
$9.3M
+203%
2020
$28.1M
+23%
2021
$34.5M
+1%
2022
$34.9M
+11%
2023
$38.7M
-12%
2024
$34.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (J9271 (Injection, pembrolizumab, 1 mg)) accounts for 7% of total spending.

J9271Normal range

Injection, pembrolizumab, 1 mg

$11.8M

2K claims · 6.6%

Your Cost: $7,238.97/claim|Median: $5,391.55
1.3× median
99284Top 10%

Emergency dept visit, high complexity

$10.5M

61K claims · 5.8%

Your Cost: $171.94/claim|Median: $69.51
2.5× median
99283Top 10%

Emergency dept visit, moderate complexity

$9.1M

50K claims · 5.1%

Your Cost: $182.62/claim|Median: $42.48
4.3× median
99213Top 1%

Office/outpatient visit, est. patient, low-mod complexity

$7.7M

47K claims · 4.3%

Your Cost: $164.28/claim|Median: $37.81
4.3× median
99214Top 5%

Office/outpatient visit, est. patient, mod-high complexity

$7.1M

41K claims · 4.0%

Your Cost: $173.42/claim|Median: $53.41
3.3× median
96365Top 10%

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$5.2M

29K claims · 2.9%

Your Cost: $177.76/claim|Median: $54.77
3.3× median
U0004Top 25%

COVID-19 test, nucleic acid detection, CDC lab only

$5.0M

67K claims · 2.8%

Your Cost: $74.66/claim|Median: $60.05
1.2× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$4.9M

4K claims · 2.7%

Your Cost: $1,115.72/claim|Median: $763.43
1.5× median
96361Top 25%

IV infusion, hydration, each additional hour

$4.9M

21K claims · 2.7%

Your Cost: $237.57/claim|Median: $38.92
6.1× median
97110Top 1%

Therapeutic exercises, each 15 min

$4.2M

29K claims · 2.3%

Your Cost: $142.81/claim|Median: $24.49
5.8× median
99282Top 5%

Emergency dept visit, low complexity

$4.1M

22K claims · 2.3%

Your Cost: $190.74/claim|Median: $37.72
5.1× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$4.1M

28K claims · 2.3%

Your Cost: $144.09/claim|Median: $85.65
1.7× median
87633Normal range

Respiratory virus detection, 12-25 targets, nucleic acid

$3.6M

61K claims · 2.0%

Your Cost: $59.31/claim|Median: $169.17
0.3× median
70450Top 5%

CT head/brain without contrast

$2.8M

8K claims · 1.5%

Your Cost: $325.58/claim|Median: $45.53
7.2× median
93976Top 1%

$2.6M

6K claims · 1.5%

Your Cost: $467.14/claim|Median: $42.06
11.1× median
97530Top 5%

Therapeutic activities, each 15 min

$2.3M

17K claims · 1.3%

Your Cost: $136.16/claim|Median: $33.11
4.1× median
G0378Normal range

Hospital observation service, per hour

$2.3M

11K claims · 1.3%

Your Cost: $219.72/claim|Median: $99.39
2.2× median
74177Top 25%

CT abdomen and pelvis with contrast

$2.3M

9K claims · 1.3%

Your Cost: $242.14/claim|Median: $65.76
3.7× median
80053Top 25%

Comprehensive metabolic panel

$2.1M

117K claims · 1.2%

Your Cost: $17.94/claim|Median: $7.24
2.5× median
87486Top 25%

$2.1M

61K claims · 1.2%

Your Cost: $34.16/claim|Median: $19.16
1.8× median
99281Top 10%

Emergency dept visit, minimal complexity

$1.9M

10K claims · 1.1%

Your Cost: $191.85/claim|Median: $52.03
3.7× median
D0999Normal range

Unspecified diagnostic procedure, by report

$1.9M

13K claims · 1.0%

Your Cost: $148.39/claim|Median: $101.33
1.5× median
76770Top 1%

Ultrasound, retroperitoneal, complete

$1.8M

7K claims · 1.0%

Your Cost: $281.49/claim|Median: $37.35
7.5× median
96413Top 25%

Chemotherapy administration, IV infusion, up to 1 hour

$1.8M

11K claims · 1.0%

Your Cost: $161.18/claim|Median: $75.28
2.1× median
96366Top 25%

IV infusion, therapeutic/prophylactic/diagnostic, each additional hour

$1.8M

9K claims · 1.0%

Your Cost: $189.76/claim|Median: $40.12
4.7× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$1.7M

46K claims · 1.0%

Your Cost: $37.76/claim|Median: $39.70
0.9× median
99212Top 5%

Office/outpatient visit, low complexity

$1.7M

10K claims · 1.0%

Your Cost: $177.13/claim|Median: $25.06
7.1× median
90834Top 5%

Psychotherapy, 45 minutes

$1.7M

11K claims · 0.9%

Your Cost: $149.29/claim|Median: $63.65
2.4× median
99215Top 5%

Office/outpatient visit, high complexity

$1.6M

9K claims · 0.9%

Your Cost: $185.02/claim|Median: $74.09
2.5× median
70553Top 25%

MRI brain without contrast, then with contrast

$1.6M

4K claims · 0.9%

Your Cost: $348.49/claim|Median: $133.68
2.6× median