Regents of the University of California
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 82 procedure codes: 77386 at 4.0× median, J1745 at 2.7× 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.
Risk Assessment
Bills $1,031.37 per claim for 77386 (Intensity modulated radiation treatment delivery, complex) — 4.0× the national median of $260.56.
Bills $1,480.25 per claim for 78815 (PET imaging for limited area) — 4.5× the national median of $325.10.
Bills $2,183.41 per claim for J9035 (Injection, bevacizumab, 10 mg) — 50.0× the national median of $43.71.
Billing above the 90th percentile for 6 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 $265.0M is at the 75th percentile among 156 General Acute Care Hospital providers.
Total Paid
$265.0M
$264,994,584
Total Claims
4.2M
Beneficiaries
3.4M
1.2 claims/patient
Avg Cost/Claim
$63
#302 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Regents of the University of California is a General Acute Care Hospital provider based in San Diego, CA. From the 2018–2024 period, this provider received $265.0M in Medicaid payments across 4.2M claims.
Why This Matters
This provider received $265.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 33,124 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 (J9271 (Injection, pembrolizumab, 1 mg)) accounts for 9% of total spending.
$24.2M
6K claims
$3,880.98
$5,391.55
Injection, pembrolizumab, 1 mg
$24.2M
6K claims · 9.1%
$19.9M
19K claims
$1,031.37
$260.56
Intensity modulated radiation treatment delivery, complex
$19.9M
19K claims · 7.5%
$10.4M
4K claims
$2,611.46
$3,562.28
Nivolumab (Opdivo) injection, 1 mg
$10.4M
4K claims · 3.9%
$9.6M
2K claims
$4,233.81
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$9.6M
2K claims · 3.6%
$8.6M
2K claims · 3.2%
Revenue code, clinic services
$7.1M
206K claims · 2.7%
PET imaging for limited area
$6.8M
5K claims · 2.6%
$6.4M
4K claims · 2.4%
$5.6M
2K claims · 2.1%
Injection, bevacizumab, 10 mg
$5.6M
3K claims · 2.1%
CT abdomen and pelvis with contrast
$4.1M
20K claims · 1.5%
Injection, omalizumab, 5 mg
$3.6M
2K claims · 1.4%
Emergency room visit
$3.6M
52K claims · 1.4%
Hospital outpatient clinic visit
$3.2M
98K claims · 1.2%
$3.1M
2K claims · 1.2%
$3.1M
3K claims · 1.2%
$3.1M
3K claims · 1.2%
CT chest with contrast
$2.9M
16K claims · 1.1%
$2.9M
7K claims
$427.64
$133.68
MRI brain without contrast, then with contrast
$2.9M
7K claims · 1.1%
Unclassified drugs
$2.8M
128K claims · 1.1%
Comprehensive metabolic panel
$2.7M
244K claims · 1.0%
$2.5M
739 claims · 1.0%
$2.5M
2K claims · 0.9%
$2.4M
34K claims
$70.46
$42.48
Emergency dept visit, moderate complexity
$2.4M
34K claims · 0.9%
$2.2M
31K claims
$71.17
$63.08
Infectious disease detection (COVID-19)
$2.2M
31K claims · 0.8%
$2.1M
10K claims
$220.91
$54.68
Echocardiography, transthoracic, complete, with Doppler
$2.1M
10K claims · 0.8%
$2.1M
561 claims · 0.8%
$1.9M
36K claims
$52.98
$14.92
Therapeutic/prophylactic/diagnostic IV push, each additional substance
$1.9M
36K claims · 0.7%
$1.8M
34K claims
$53.88
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$1.8M
34K claims · 0.7%
$1.7M
24K claims
$73.45
$30.88
Unlisted evaluation and management service
$1.7M
24K claims · 0.7%
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