North Shore University Hospital
Case Management
New Hyde Park, New York
NPI: 1932472107
Risk Tier
High
Total Paid
$166.5M
$166,534,128
Total Claims
506K
Beneficiaries
504K
Avg Cost/Claim
$329.28
Active billing period: 78 months (2018-07 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $309.83 per claim for G9005 (Coordinated care fee, risk-adjusted, ESRD), which is 6.6× the national median of $47.08.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $6.1M (2019) to $19.6M (2020) — a 221% swing with $13.5M absolute change.
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