Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Brigham & Womens Hospital Inc.

General Acute Care Hospital

Boston, Massachusetts

NPI: 1790717650

Risk Tier

Elevated

Total Paid

$252.6M

$252,584,160

Total Claims

6.3M

Beneficiaries

5.5M

Avg Cost/Claim

$40.03

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 92 procedure codes: 99211 at 9.8× median, 99213 at 2.4× median.

Advanced Detection Signals

Billing Velocity

3414.8 claims per working day — may exceed physically possible volume for a single provider.

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