Children's Specialized Hospital
Pediatrics
New Brunswick, New Jersey
NPI: 1396886297
Risk Tier
Elevated
Total Paid
$199.9M
$199,938,875
Total Claims
1.1M
Beneficiaries
549K
Avg Cost/Claim
$186.63
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 70 procedure codes: 97530 at 5.3× median, 92507 at 4.5× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024