United Health Services Hospitals, Inc.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $7.0M (2019) to $22.6M (2020) — a 226% swing with $15.7M absolute change.
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:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $608.55 per claim for 90791 (Psychiatric diagnostic evaluation) — 6.1× the national median of $99.21.
Bills $241.79 per claim for 96361 (IV infusion, hydration, each additional hour) — 6.2× the national median of $38.92.
Bills $157.54 per claim for 99283 (Emergency dept visit, moderate complexity) — 3.7× the national median of $42.48.
Billing in the top 1% nationally for 1 procedure code: 90791.
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 $163.2M is at the 25th percentile among 156 General Acute Care Hospital providers.
Total Paid
$163.2M
$163,202,795
Total Claims
2.8M
Beneficiaries
2.2M
1.2 claims/patient
Avg Cost/Claim
$59
#624 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
United Health Services Hospitals, Inc. is a General Acute Care Hospital provider based in Binghamton, NY. From the 2018–2024 period, this provider received $163.2M in Medicaid payments across 2.8M claims.
Why This Matters
This provider received $163.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 20,400 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 (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 16% of total spending.
$25.9M
231K claims
$112.39
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$25.9M
231K claims · 15.9%
$15.8M
141K claims
$112.31
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$15.8M
141K claims · 9.7%
Psychiatric diagnostic evaluation
$6.4M
11K claims · 3.9%
$5.0M
182K claims
$27.40
$18.95
Alcohol/drug services; methadone administration
$5.0M
182K claims · 3.1%
$4.5M
19K claims
$241.79
$38.92
IV infusion, hydration, each additional hour
$4.5M
19K claims · 2.8%
$4.3M
29K claims
$150.65
$69.51
Emergency dept visit, high complexity
$4.3M
29K claims · 2.7%
$4.1M
27K claims
$155.14
$85.65
Emergency dept visit, high/urgent complexity
$4.1M
27K claims · 2.5%
$3.6M
23K claims
$157.54
$42.48
Emergency dept visit, moderate complexity
$3.6M
23K claims · 2.2%
$3.3M
16K claims
$208.39
$73.29
Medication-assisted treatment, opioid use disorder, per month
$3.3M
16K claims · 2.0%
Psychotherapy, 30 minutes
$2.9M
26K claims · 1.8%
Therapeutic exercises, each 15 min
$2.7M
52K claims · 1.7%
$2.7M
24K claims
$114.46
$57.85
Office/outpatient visit, new patient, low-mod complexity
$2.7M
24K claims · 1.7%
$2.7M
35K claims
$75.40
$63.08
Infectious disease detection (COVID-19)
$2.7M
35K claims · 1.6%
CT abdomen and pelvis with contrast
$2.6M
8K claims · 1.6%
Comprehensive metabolic panel
$2.4M
117K claims · 1.5%
CT head/brain without contrast
$2.3M
8K claims · 1.4%
$2.1M
7K claims
$286.34
$47.08
Coordinated care fee, risk-adjusted, ESRD
$2.1M
7K claims · 1.3%
Upper GI endoscopy with biopsy
$2.0M
3K claims · 1.2%
$1.9M
13K claims
$150.40
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$1.9M
13K claims · 1.2%
$1.8M
16K claims
$113.88
$25.06
Office/outpatient visit, low complexity
$1.8M
16K claims · 1.1%
$1.7M
15K claims
$113.56
$75.18
Preventive medicine, established patient, age 1-4
$1.7M
15K claims · 1.0%
$1.6M
14K claims
$116.36
$69.35
Preventive medicine, established patient, infant (under 1)
$1.6M
14K claims · 1.0%
Fetal non-stress test
$1.6M
10K claims · 1.0%
$1.6M
13K claims
$116.49
$84.03
Office/outpatient visit, new patient, mod-high complexity
$1.6M
13K claims · 1.0%
Psychotherapy, 45 minutes
$1.5M
11K claims · 0.9%
$1.5M
13K claims
$117.45
$74.82
Preventive medicine, established patient, age 5-11
$1.5M
13K claims · 0.9%
$1.4M
12K claims
$115.29
$72.71
Preventive medicine, established patient, age 18-39
$1.4M
12K claims · 0.9%
$1.2M
29K claims
$42.86
$28.46
Streptococcus Group A detection, nucleic acid, amplified probe
$1.2M
29K claims · 0.8%
$1.2M
4K claims
$333.35
$60.19
CT abdomen and pelvis without contrast
$1.2M
4K claims · 0.7%
$1.2M
10K claims
$114.82
$76.06
Preventive medicine, established patient, age 40-64
$1.2M
10K claims · 0.7%
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