St Josephs University Medical Center Inc.
General Acute Care Hospital
Paterson, New Jersey
NPI: 1669462420
Risk Tier
High
Total Paid
$322.4M
$322,401,873
Total Claims
4.7M
Beneficiaries
3.9M
Avg Cost/Claim
$68.13
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $352.94 per claim for 99284 (Emergency dept visit, high complexity), which is 5.1× the national median of $69.51.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 97 procedure codes: 99284 at 5.1× median, 99283 at 7.0× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024