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

Nyu Langone Hospitals

Clinic/Center, Oncology

New York, New York

NPI: 1801992631

Risk Tier

High

Total Paid

$238.7M

$238,686,702

Total Claims

4.7M

Beneficiaries

4.2M

Avg Cost/Claim

$50.94

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (2)

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 169 procedure codes: G0378 at 12.1× median, 99283 at 5.9× median.

Explosive Growth

Billing increased over 500% year-over-year — far beyond normal growth patterns.

Billing grew 527% from 2018 to 2019.

Advanced Detection Signals

CUSUM Change Point

Billing shifted 4.4x in 2020-05 — a statistically significant structural change in billing behavior was detected.

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