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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. States
  3. New Jersey
  4. Fraud Risk

Medicare Fraud Risk in New Jersey

15 flagged providers identified through statistical analysis of billing anomalies.

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Flagged Providers

15

Average Risk Score

75/100

State Markup Ratio

3.9x

National avg: 3.8x

Total Medicare Payments

$36.6B

🔥 Fraud Hotspots in New Jersey

Cities with the most flagged providers based on billing anomaly analysis.

Clifton2 flagged providers
Livingston2 flagged providers
Raritan1 flagged provider
Ridgewood1 flagged provider
Cedar Knolls1 flagged provider
Elmwood Park1 flagged provider
Cape May Court House1 flagged provider
Freehold1 flagged provider
Hackettstown1 flagged provider
Howell1 flagged provider

Flagged Providers in New Jersey

ProviderSpecialtyCityRisk ScoreTotal PaymentsMarkup
Quest Diagnostics IncorporatedClinical LaboratoryClifton90$111.2M9.3x
Laboratory Corporation Of America HoldingsClinical LaboratoryRaritan89$143.3M8.6x
Tatiana SharahyInternal MedicineRidgewood88$5.7M197.7x
Centers Lab Nj LlcClinical LaboratoryCedar Knolls85$15.4M14.3x
Bioreference Health, LlcClinical LaboratoryElmwood Park83$66.8M6.3x
Ednan SheikhAnesthesiologyClifton74$589.5K171.7x
Richard FalivenaGeneral SurgeryCape May Court House73$207.2K27.1x
Bhavesh BalarHematology-OncologyFreehold71$4.2M19.4x
Paul LittmanObstetrics & GynecologyHackettstown69$346.6K9.7x
Atlantic Ambulance Corp.Ambulance Service ProviderLivingston68$8.8M6.6x
Kenneth NahumHematology-OncologyHowell68$3.2M19.2x
Saint Barnabas Outpatient CentersIndependent Diagnostic Testing Facility (IDTF)Livingston68$3.1M26.9x
Jumana ChatiwalaHematologySparta68$1.3M15.7x
Accu Reference Medical Lab, LlcClinical LaboratoryLinden66$21.2M1.5x
Myron BednarHematologyFlemington66$2.5M8.6x

Compared to Neighboring States

StateFlagged ProvidersMarkup Ratio
New Jersey (this state)153.9x
Delaware13.4x
New York393.8x
Pennsylvania163.5x

⚠️ Disclaimer: Being flagged does not imply fraud. These providers were identified through statistical analysis of billing patterns that deviate significantly from peers. Unusual billing may have legitimate explanations. This data is provided for transparency and public accountability purposes only.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • OpenMedicare Statistical Anomaly Detection

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.