Elwyn New Jersey
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T2021 (2 unique codes).
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:
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Extreme procedure concentration — 88% of all billing flows through just 2 codes (H2016, T2021).
This is a statistical summary, not an accusation. See our methodology.
Compared to Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities Peers
Total spending distribution among 50 providers in this specialty
This provider's total spending of $206.6M is at the 75th percentile among 50 Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers.
Extreme procedure concentration — 88% of $206.6M billed through just 2 codes
Total Paid
$206.6M
$206,621,412
Total Claims
439K
Beneficiaries
26K
16.9 claims/patient
Avg Cost/Claim
$471
#432 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Elwyn New Jersey is a Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities provider based in Vineland, NJ. From the 2018–2024 period, this provider received $206.6M in Medicaid payments across 439K claims.
Why This Matters
This provider received $206.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,827 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 2 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 88% of total spending.
$182.3M
255K claims
$715.06
$321.53
Comprehensive community support services, per 15 min
$182.3M
255K claims · 88.2%
$24.3M
184K claims
$132.51
$150.51
Day habilitation, waiver; per 15 min
$24.3M
184K claims · 11.8%
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