Hmh Hospitals Corporation
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 123 procedure codes: 99284 at 5.7× median, 99283 at 6.9× 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 $398.50 per claim for 99284 (Emergency dept visit, high complexity) — 5.7× the national median of $69.51.
Bills $291.76 per claim for 99283 (Emergency dept visit, moderate complexity) — 6.9× the national median of $42.48.
Bills $1,000.65 per claim for G0378 (Hospital observation service, per hour) — 10.1× the national median of $99.39.
Billing in the top 1% nationally for 6 procedure codes: J1745, 96375, 43239.
This is a statistical summary, not an accusation. See our methodology.
Compared to Ambulance Peers
Total spending distribution among 12 providers in this specialty
This provider's total spending of $333.0M is at the 90th percentile among 12 Ambulance providers.
Above 90th percentile for this specialty — higher spending than 10 of 12 peers
Total Paid
$333.0M
$333,032,794
Total Claims
3.5M
Beneficiaries
2.8M
1.3 claims/patient
Avg Cost/Claim
$94
#211 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Hmh Hospitals Corporation is a Ambulance provider based in Hackensack, NJ. From the 2018–2024 period, this provider received $333.0M in Medicaid payments across 3.5M claims.
Why This Matters
This provider received $333.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 41,629 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 10% of total spending.
$33.7M
85K claims
$398.50
$69.51
Emergency dept visit, high complexity
$33.7M
85K claims · 10.1%
$31.2M
107K claims
$291.76
$42.48
Emergency dept visit, moderate complexity
$31.2M
107K claims · 9.4%
$19.3M
19K claims
$1,000.65
$99.39
Hospital observation service, per hour
$19.3M
19K claims · 5.8%
Injection, pembrolizumab, 1 mg
$17.0M
2K claims · 5.1%
$12.3M
31K claims
$390.48
$85.65
Emergency dept visit, high/urgent complexity
$12.3M
31K claims · 3.7%
$11.7M
31K claims
$380.90
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$11.7M
31K claims · 3.5%
$10.7M
1K claims
$9,014.48
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$10.7M
1K claims · 3.2%
$7.1M
1K claims · 2.1%
$6.7M
47K claims
$144.29
$14.92
Therapeutic/prophylactic/diagnostic IV push, each additional substance
$6.7M
47K claims · 2.0%
$5.7M
831 claims · 1.7%
Emergency dept visit, low complexity
$5.7M
25K claims · 1.7%
Upper GI endoscopy with biopsy
$5.0M
3K claims · 1.5%
$5.0M
773 claims
$6,455.25
$3,562.28
Nivolumab (Opdivo) injection, 1 mg
$5.0M
773 claims · 1.5%
Ambulance, BLS emergency transport
$4.9M
20K claims · 1.5%
$4.7M
30K claims
$155.28
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$4.7M
30K claims · 1.4%
CT abdomen and pelvis with contrast
$3.9M
18K claims · 1.2%
$3.8M
2K claims · 1.1%
$3.6M
34K claims
$107.70
$38.92
IV infusion, hydration, each additional hour
$3.6M
34K claims · 1.1%
$3.5M
2K claims · 1.1%
$3.5M
7K claims
$497.70
$54.68
Echocardiography, transthoracic, complete, with Doppler
$3.5M
7K claims · 1.0%
$3.4M
11K claims
$314.71
$164.22
Ambulance, ALS emergency transport Level 1
$3.4M
11K claims · 1.0%
PET imaging for limited area
$3.1M
3K claims · 0.9%
$2.9M
933 claims · 0.9%
$2.9M
5K claims
$579.42
$133.68
MRI brain without contrast, then with contrast
$2.9M
5K claims · 0.9%
$2.8M
7K claims · 0.9%
$2.7M
338 claims · 0.8%
$2.6M
458 claims · 0.8%
$2.3M
680 claims · 0.7%
$2.3M
2K claims · 0.7%
Colonoscopy with biopsy
$2.2M
2K claims · 0.6%
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