County of Los Angeles Auditor Controller
General Acute Care Hospital
Sylmar, California
NPI: 1316969934
Risk Tier
High
Total Paid
$66.6M
$66,605,756
Total Claims
75K
Beneficiaries
59K
Avg Cost/Claim
$887.91
Statistical Risk Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
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).
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