Inspira Medical Centers Inc.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 68 procedure codes: 99284 at 8.3× median, 99283 at 9.0× 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:
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 $580.37 per claim for 99284 (Emergency dept visit, high complexity) — 8.3× the national median of $69.51.
Bills $382.62 per claim for 99283 (Emergency dept visit, moderate complexity) — 9.0× the national median of $42.48.
Bills $695.21 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 8.1× the national median of $85.65.
Billing in the top 1% nationally for 7 procedure codes: 99284, 99283, 99285.
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 $227.1M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$227.1M
$227,071,354
Total Claims
3.3M
Beneficiaries
2.7M
1.2 claims/patient
Avg Cost/Claim
$70
#370 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Inspira Medical Centers Inc. is a General Acute Care Hospital provider based in Vineland, NJ. From the 2018–2024 period, this provider received $227.1M in Medicaid payments across 3.3M claims.
Why This Matters
This provider received $227.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 28,383 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 23% of total spending.
$51.6M
89K claims
$580.37
$69.51
Emergency dept visit, high complexity
$51.6M
89K claims · 22.7%
$39.9M
104K claims
$382.62
$42.48
Emergency dept visit, moderate complexity
$39.9M
104K claims · 17.6%
$33.3M
48K claims
$695.21
$85.65
Emergency dept visit, high/urgent complexity
$33.3M
48K claims · 14.7%
$13.0M
16K claims
$812.04
$99.39
Hospital observation service, per hour
$13.0M
16K claims · 5.7%
$12.7M
39K claims
$324.62
$148.53
Mental health partial hospitalization, treatment, per hour
$12.7M
39K claims · 5.6%
Emergency dept visit, low complexity
$7.4M
31K claims · 3.3%
$5.1M
18K claims
$280.32
$164.22
Ambulance, ALS emergency transport Level 1
$5.1M
18K claims · 2.2%
Fetal non-stress test
$3.8M
11K claims · 1.7%
$3.4M
22K claims
$153.99
$138.19
Ambulance, BLS emergency transport
$3.4M
22K claims · 1.5%
Psychotherapy, 60 minutes
$2.8M
29K claims · 1.2%
Ambulance, specialty care transport
$2.6M
6K claims · 1.1%
Ground mileage, per statute mile
$2.0M
54K claims · 0.9%
$1.9M
5K claims
$418.20
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.9M
5K claims · 0.8%
Upper GI endoscopy with biopsy
$1.6M
992 claims · 0.7%
$1.4M
60K claims
$22.54
$7.50
Electrocardiogram, tracing only, without interpretation
$1.4M
60K claims · 0.6%
$1.2M
22K claims
$55.15
$49.45
Speech/hearing/language treatment
$1.2M
22K claims · 0.5%
Critical care, first 30-74 minutes
$1.2M
2K claims · 0.5%
$1.1M
3K claims
$414.48
$106.79
Ultrasound, pregnant uterus, detailed, single fetus
$1.1M
3K claims · 0.5%
$1.1M
699 claims
$1,568.95
$233.73
Polysomnography, sleep study, 6+ hours
$1.1M
699 claims · 0.5%
Tympanostomy, general anesthesia
$1.1M
459 claims · 0.5%
$1.0M
34K claims
$29.13
$33.11
Therapeutic activities, each 15 min
$1.0M
34K claims · 0.4%
$974K
16K claims
$61.96
$65.76
CT abdomen and pelvis with contrast
$974K
16K claims · 0.4%
$841K
6K claims
$130.30
$39.33
Screening mammography, bilateral, including CAD
$841K
6K claims · 0.4%
$815K
43K claims
$18.92
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$815K
43K claims · 0.4%
$811K
1K claims
$675.58
$127.34
MRI joint of lower extremity without contrast
$811K
1K claims · 0.4%
$792K
26K claims
$30.60
$16.79
Manual therapy techniques, per 15 minutes
$792K
26K claims · 0.3%
Ultrasound, pelvic, complete
$779K
7K claims · 0.3%
PET imaging for limited area
$775K
536 claims · 0.3%
Ultrasound, pregnant uterus, follow-up
$770K
9K claims · 0.3%
$764K
68K claims
$11.24
$24.49
Therapeutic exercises, each 15 min
$764K
68K claims · 0.3%
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