County of Los Angeles Auditor Controller
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $911.11 per claim for T1015 (Clinic visit/encounter, all-inclusive), which is 7.5× the national median of $121.16.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T1015 (2 unique codes).
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $66.6M is at the below 25th percentile among 156 General Acute Care Hospital providers.
Total Paid
$66.6M
$66,605,756
Total Claims
75K
Beneficiaries
59K
1.3 claims/patient
Avg Cost/Claim
$888
🔍 Analysis
Provider Overview
County of Los Angeles Auditor Controller is a General Acute Care Hospital provider based in Sylmar, CA. From the 2018–2024 period, this provider received $66.6M in Medicaid payments across 75K claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
At $66.6M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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