Ohiohealth Corporation
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 86 procedure codes: 99283 at 3.6× median, 99284 at 2.7× 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 $152.62 per claim for 99283 (Emergency dept visit, moderate complexity) — 3.6× the national median of $42.48.
Bills $336.71 per claim for 96361 (IV infusion, hydration, each additional hour) — 8.7× the national median of $38.92.
Bills $119.79 per claim for 99282 (Emergency dept visit, low complexity) — 3.2× the national median of $37.72.
Billing in the top 1% nationally for 1 procedure code: 76816.
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 $215.0M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$215.0M
$214,992,042
Total Claims
4.2M
Beneficiaries
3.4M
1.2 claims/patient
Avg Cost/Claim
$51
#404 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Ohiohealth Corporation is a General Acute Care Hospital provider based in Columbus, OH. From the 2018–2024 period, this provider received $215.0M in Medicaid payments across 4.2M claims.
Why This Matters
This provider received $215.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,874 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 18% of total spending.
$39.3M
258K claims
$152.62
$42.48
Emergency dept visit, moderate complexity
$39.3M
258K claims · 18.3%
$33.3M
177K claims
$187.60
$69.51
Emergency dept visit, high complexity
$33.3M
177K claims · 15.5%
$28.8M
86K claims
$336.71
$38.92
IV infusion, hydration, each additional hour
$28.8M
86K claims · 13.4%
$16.4M
77K claims
$213.40
$85.65
Emergency dept visit, high/urgent complexity
$16.4M
77K claims · 7.6%
Emergency dept visit, low complexity
$9.1M
76K claims · 4.2%
CT head/brain without contrast
$7.4M
28K claims · 3.5%
$6.6M
311 claims
$21,288.73
$17,264.74
Ocrelizumab (Ocrevus) injection, 1 mg
$6.6M
311 claims · 3.1%
CT abdomen and pelvis with contrast
$6.1M
20K claims · 2.9%
$5.1M
61K claims
$82.55
$99.39
Hospital observation service, per hour
$5.1M
61K claims · 2.4%
Injection, pembrolizumab, 1 mg
$4.5M
522 claims · 2.1%
CT angiography, chest, with contrast
$3.0M
13K claims · 1.4%
$2.9M
574 claims
$5,056.23
$2,797.07
Injection, natalizumab, one milligram
$2.9M
574 claims · 1.3%
$2.6M
17K claims
$150.85
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$2.6M
17K claims · 1.2%
$2.4M
8K claims
$290.47
$60.19
CT abdomen and pelvis without contrast
$2.4M
8K claims · 1.1%
$2.3M
10K claims
$226.31
$61.57
IV infusion, hydration, initial, 31 minutes to 1 hour
$2.3M
10K claims · 1.1%
$2.2M
9K claims
$256.18
$40.12
IV infusion, therapeutic/prophylactic/diagnostic, each additional hour
$2.2M
9K claims · 1.0%
$2.1M
16K claims
$133.95
$10.88
Pressurized or nonpressurized inhalation treatment
$2.1M
16K claims · 1.0%
$1.1M
7K claims · 0.5%
$1.0M
449 claims
$2,325.85
$1,115.75
Total knee replacement surgery, both components
$1.0M
449 claims · 0.5%
Basic metabolic panel
$1.0M
107K claims · 0.5%
$1.0M
3K claims · 0.5%
Ultrasound, pregnant uterus, follow-up
$894K
4K claims · 0.4%
$883K
7K claims
$125.35
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$883K
7K claims · 0.4%
$802K
6K claims · 0.4%
$781K
3K claims
$279.80
$54.68
Echocardiography, transthoracic, complete, with Doppler
$781K
3K claims · 0.4%
$731K
120K claims
$6.11
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$731K
120K claims · 0.3%
$715K
86K claims
$8.31
$14.92
Therapeutic/prophylactic/diagnostic IV push, each additional substance
$715K
86K claims · 0.3%
Fetal non-stress test
$697K
4K claims · 0.3%
$629K
200 claims · 0.3%
Comprehensive metabolic panel
$624K
65K claims · 0.3%
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