Hartford Hospital
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 81 procedure codes: 99285 at 6.1× median, 99284 at 4.2× 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.
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 $522.32 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 6.1× the national median of $85.65.
Bills $291.37 per claim for 99284 (Emergency dept visit, high complexity) — 4.2× the national median of $69.51.
Bills $87.72 per claim for G0463 (Hospital outpatient clinic visit) — 3.3× the national median of $26.41.
Billing above the 90th percentile for 14 procedure codes simultaneously.
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 $316.3M is at the 75th percentile among 156 General Acute Care Hospital providers.
Total Paid
$316.3M
$316,278,903
Total Claims
7.4M
Beneficiaries
4.6M
1.6 claims/patient
Avg Cost/Claim
$43
#229 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Hartford Hospital is a General Acute Care Hospital provider based in Hartford, CT. From the 2018–2024 period, this provider received $316.3M in Medicaid payments across 7.4M claims.
Why This Matters
This provider received $316.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 39,534 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 (99285 (Emergency dept visit, high/urgent complexity)) accounts for 17% of total spending.
$55.0M
105K claims
$522.32
$85.65
Emergency dept visit, high/urgent complexity
$55.0M
105K claims · 17.4%
$31.1M
107K claims
$291.37
$69.51
Emergency dept visit, high complexity
$31.1M
107K claims · 9.8%
Hospital outpatient clinic visit
$25.7M
293K claims · 8.1%
Therapeutic exercises, each 15 min
$21.7M
403K claims · 6.9%
$18.4M
90K claims
$203.33
$42.48
Emergency dept visit, moderate complexity
$18.4M
90K claims · 5.8%
$8.6M
85K claims
$101.64
$135.70
Intensive outpatient psychiatric services, per diem
$8.6M
85K claims · 2.7%
$8.5M
2K claims
$5,038.70
$5,391.55
Injection, pembrolizumab, 1 mg
$8.5M
2K claims · 2.7%
$7.4M
53K claims
$140.80
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$7.4M
53K claims · 2.3%
$4.3M
6K claims
$685.18
$268.70
Extracapsular cataract removal with IOL insertion
$4.3M
6K claims · 1.4%
Fetal non-stress test
$3.2M
20K claims · 1.0%
$3.1M
17K claims
$177.21
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$3.1M
17K claims · 1.0%
$3.0M
2K claims
$1,864.10
$1,650.68
Ambulance service, conventional air, transport, one way
$3.0M
2K claims · 1.0%
Hot/cold packs application
$3.0M
112K claims · 0.9%
$2.9M
24K claims
$119.30
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$2.9M
24K claims · 0.9%
$2.8M
536 claims · 0.9%
$2.7M
18K claims
$149.71
$65.76
CT abdomen and pelvis with contrast
$2.7M
18K claims · 0.9%
Chest X-ray, 2 views
$2.5M
45K claims · 0.8%
$2.3M
45K claims
$50.33
$38.92
IV infusion, hydration, each additional hour
$2.3M
45K claims · 0.7%
$2.2M
454 claims · 0.7%
Hemodialysis, one evaluation
$2.2M
6K claims · 0.7%
Upper GI endoscopy with biopsy
$2.2M
6K claims · 0.7%
$2.1M
2K claims
$1,303.70
$183.33
Left heart catheterization with imaging
$2.1M
2K claims · 0.7%
Colonoscopy with biopsy
$2.1M
3K claims · 0.7%
$2.0M
13K claims
$154.69
$148.53
Mental health partial hospitalization, treatment, per hour
$2.0M
13K claims · 0.6%
CT cervical spine without contrast
$2.0M
12K claims · 0.6%
Critical care, first 30-74 minutes
$2.0M
3K claims · 0.6%
$2.0M
3K claims
$693.58
$233.73
Polysomnography, sleep study, 6+ hours
$2.0M
3K claims · 0.6%
$1.9M
30K claims
$64.20
$60.05
COVID-19 test, nucleic acid detection, CDC lab only
$1.9M
30K claims · 0.6%
$1.9M
34K claims
$56.66
$47.89
Physical therapy evaluation, low complexity
$1.9M
34K claims · 0.6%
$1.8M
15K claims
$119.69
$61.57
IV infusion, hydration, initial, 31 minutes to 1 hour
$1.8M
15K claims · 0.6%
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