New York City Health and Hospitals Corporation
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $7.4M (2019) to $27.8M (2020) — a 276% swing with $20.4M absolute change.
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:
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
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $154.21 per claim for 99283 (Emergency dept visit, moderate complexity) — 3.6× the national median of $42.48.
Bills $696.13 per claim for 90791 (Psychiatric diagnostic evaluation) — 7.0× the national median of $99.21.
Bills $138.40 per claim for 90832 (Psychotherapy, 30 minutes) — 3.4× the national median of $41.28.
Billing in the top 1% nationally for 1 procedure code: 90791.
This is a statistical summary, not an accusation. See our methodology.
Compared to Internal Medicine Peers
Total spending distribution among 26 providers in this specialty
This provider's total spending of $178.8M is at the 90th percentile among 26 Internal Medicine providers.
Above 90th percentile for this specialty — higher spending than 23 of 26 peers
Total Paid
$178.8M
$178,841,758
Total Claims
3.8M
Beneficiaries
3.2M
1.2 claims/patient
Avg Cost/Claim
$47
#535 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
New York City Health and Hospitals Corporation is a Internal Medicine provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $178.8M in Medicaid payments across 3.8M claims.
Why This Matters
This provider received $178.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 22,355 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 (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 9% of total spending.
$15.6M
177K claims
$88.46
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$15.6M
177K claims · 8.7%
$15.3M
99K claims
$154.21
$42.48
Emergency dept visit, moderate complexity
$15.3M
99K claims · 8.5%
$11.8M
74K claims
$159.14
$69.51
Emergency dept visit, high complexity
$11.8M
74K claims · 6.6%
$10.2M
93K claims
$108.98
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$10.2M
93K claims · 5.7%
Psychiatric diagnostic evaluation
$9.6M
14K claims · 5.4%
$7.0M
104K claims
$67.19
$63.08
Infectious disease detection (COVID-19)
$7.0M
104K claims · 3.9%
Psychotherapy, 30 minutes
$6.5M
47K claims · 3.6%
$6.2M
161K claims
$38.74
$18.95
Alcohol/drug services; methadone administration
$6.2M
161K claims · 3.5%
Emergency dept visit, low complexity
$5.8M
34K claims · 3.2%
$3.7M
3K claims
$1,152.23
$99.39
Hospital observation service, per hour
$3.7M
3K claims · 2.1%
$3.5M
3K claims
$1,129.67
$501.33
Crisis intervention mental health services, per diem
$3.5M
3K claims · 2.0%
Psychotherapy, 45 minutes
$3.0M
16K claims · 1.7%
$2.4M
35K claims
$69.97
$25.06
Office/outpatient visit, low complexity
$2.4M
35K claims · 1.4%
$2.2M
233K claims
$9.41
$1.57
Collection of venous blood by venipuncture
$2.2M
233K claims · 1.2%
$2.1M
13K claims
$168.87
$84.03
Office/outpatient visit, new patient, mod-high complexity
$2.1M
13K claims · 1.2%
$2.0M
16K claims
$123.15
$57.85
Office/outpatient visit, new patient, low-mod complexity
$2.0M
16K claims · 1.1%
$2.0M
10K claims
$197.94
$85.65
Emergency dept visit, high/urgent complexity
$2.0M
10K claims · 1.1%
$2.0M
113K claims
$17.43
$12.93
Office/outpatient visit, minimal complexity
$2.0M
113K claims · 1.1%
$1.9M
12K claims
$152.35
$74.09
Office/outpatient visit, high complexity
$1.9M
12K claims · 1.0%
$1.8M
10K claims
$179.10
$148.53
Mental health partial hospitalization, treatment, per hour
$1.8M
10K claims · 1.0%
$1.8M
39K claims
$46.72
$35.43
Drug test, presumptive, by chemistry analyzers
$1.8M
39K claims · 1.0%
CT head/brain without contrast
$1.6M
11K claims · 0.9%
$1.5M
25K claims
$59.48
$69.35
Preventive medicine, established patient, infant (under 1)
$1.5M
25K claims · 0.8%
$1.5M
9K claims
$159.70
$101.33
Unspecified diagnostic procedure, by report
$1.5M
9K claims · 0.8%
$1.4M
17K claims
$82.40
$38.23
Ophthalmological exam, intermediate, established patient
$1.4M
17K claims · 0.8%
$1.3M
13K claims
$105.28
$47.08
Ophthalmological exam, comprehensive, established patient
$1.3M
13K claims · 0.7%
$1.2M
8K claims
$142.66
$37.60
Unspecified adjunctive procedure, by report
$1.2M
8K claims · 0.7%
$1.1M
5K claims
$211.61
$111.09
Office/outpatient visit, new patient, high complexity
$1.1M
5K claims · 0.6%
$1.1M
23K claims
$48.07
$75.18
Preventive medicine, established patient, age 1-4
$1.1M
23K claims · 0.6%
$1.1M
10K claims
$103.72
$38.92
IV infusion, hydration, each additional hour
$1.1M
10K claims · 0.6%
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