The Queens Medical Center
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 79 procedure codes: 99283 at 12.8× median, 99285 at 10.3× 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 $544.42 per claim for 99283 (Emergency dept visit, moderate complexity) — 12.8× the national median of $42.48.
Bills $882.39 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 10.3× the national median of $85.65.
Bills $620.90 per claim for 99284 (Emergency dept visit, high complexity) — 8.9× the national median of $69.51.
Billing in the top 1% nationally for 8 procedure codes: 99283, 99285, 99284.
This is a statistical summary, not an accusation. See our methodology.
Compared to Psychiatric Unit Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $200.0M is at the 50th percentile among 8 Psychiatric Unit providers.
Total Paid
$200.0M
$200,025,638
Total Claims
2.5M
Beneficiaries
2.0M
1.2 claims/patient
Avg Cost/Claim
$81
#455 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
The Queens Medical Center is a Psychiatric Unit provider based in Honolulu, HI. From the 2018–2024 period, this provider received $200.0M in Medicaid payments across 2.5M claims.
Why This Matters
This provider received $200.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,003 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 (99283 (Emergency dept visit, moderate complexity)) accounts for 19% of total spending.
$37.4M
69K claims
$544.42
$42.48
Emergency dept visit, moderate complexity
$37.4M
69K claims · 18.7%
$35.8M
41K claims
$882.39
$85.65
Emergency dept visit, high/urgent complexity
$35.8M
41K claims · 17.9%
$35.4M
57K claims
$620.90
$69.51
Emergency dept visit, high complexity
$35.4M
57K claims · 17.7%
CT abdomen and pelvis with contrast
$12.1M
15K claims · 6.0%
$7.2M
19K claims
$377.69
$99.39
Hospital observation service, per hour
$7.2M
19K claims · 3.6%
Emergency dept visit, low complexity
$5.1M
15K claims · 2.6%
$4.3M
6,147 claims
$697.83
$60.19
CT abdomen and pelvis without contrast
$4.3M
6,147 claims · 2.1%
$4.2M
2,894 claims
$1,437.83
$101.24
Critical care, first 30-74 minutes
$4.2M
2,894 claims · 2.1%
PET imaging for limited area
$3.3M
2,258 claims · 1.6%
$2.7M
27K claims
$101.98
$36.13
Debridement, subcutaneous tissue, first 20 sq cm
$2.7M
27K claims · 1.4%
$2.5M
434 claims
$5,802.46
$5,391.55
Injection, pembrolizumab, 1 mg
$2.5M
434 claims · 1.3%
Hospital outpatient clinic visit
$2.5M
49K claims · 1.2%
$2.4M
6,091 claims · 1.2%
$2.3M
9,955 claims
$226.82
$54.68
Echocardiography, transthoracic, complete, with Doppler
$2.3M
9,955 claims · 1.1%
$2.1M
6,424 claims
$332.10
$52.03
Emergency dept visit, minimal complexity
$2.1M
6,424 claims · 1.1%
Colonoscopy with biopsy
$1.9M
3,473 claims · 0.9%
$1.8M
2,311 claims
$776.58
$255.17
Colonoscopy with polyp removal, snare technique
$1.8M
2,311 claims · 0.9%
$1.4M
2,209 claims
$622.59
$106.14
Myocardial perfusion imaging, SPECT, multiple studies
$1.4M
2,209 claims · 0.7%
$1.1M
1,458 claims · 0.5%
$1.1M
8,766 claims
$122.73
$135.70
Intensive outpatient psychiatric services, per diem
$1.1M
8,766 claims · 0.5%
Upper GI endoscopy with biopsy
$1.1M
3,384 claims · 0.5%
$1.1M
2,319 claims
$458.02
$133.68
MRI brain without contrast, then with contrast
$1.1M
2,319 claims · 0.5%
$906K
2,074 claims
$436.75
$260.56
Intensity modulated radiation treatment delivery, complex
$906K
2,074 claims · 0.5%
$880K
1,541 claims · 0.4%
$853K
10K claims · 0.4%
$819K
635 claims · 0.4%
$797K
8,854 claims
$89.96
$39.33
Screening mammography, bilateral, including CAD
$797K
8,854 claims · 0.4%
$694K
279 claims · 0.3%
Group psychotherapy
$649K
11K claims · 0.3%
$631K
23K claims
$27.98
$35.43
Drug test, presumptive, by chemistry analyzers
$631K
23K claims · 0.3%
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