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

Antelope Valley Health Care District

General Acute Care Hospital·Lancaster, CA·NPI: 1366419517SharePrint Report

Red Flags Explained

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 $500.05 per claim for 99284 (Emergency dept visit, high complexity) — 7.2× the national median of $69.51.

Bills $397.33 per claim for 99283 (Emergency dept visit, moderate complexity) — 9.3× the national median of $42.48.

Bills $782.52 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 9.1× the national median of $85.65.

Billing in the top 1% nationally for 6 procedure codes: 99284, 99283, 99285.

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

P25MedianP75P90

This provider's total spending of $222.3M is at the 50th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$222.3M

$222,293,142

Total Claims

2.4M

Beneficiaries

2.2M

1.1 claims/patient

Avg Cost/Claim

$92

#383 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Antelope Valley Health Care District is a General Acute Care Hospital provider based in Lancaster, CA. From the 2018–2024 period, this provider received $222.3M in Medicaid payments across 2.4M claims.

Why This Matters

This provider received $222.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,786 Medicaid beneficiaries for a full year at average per-enrollee costs.

4% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$27.2M
+35%
2019
$36.8M
-15%
2020
$31.3M
-1%
2021
$31.0M
+16%
2022
$36.0M
-6%
2023
$33.9M
-23%
2024
$26.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 25% of total spending.

99284Top 1%

Emergency dept visit, high complexity

$55.2M

110K claims · 24.8%

Your Cost: $500.05/claim|Median: $69.51
7.2× median
99283Top 1%

Emergency dept visit, moderate complexity

$37.0M

93K claims · 16.6%

Your Cost: $397.33/claim|Median: $42.48
9.3× median
99285Top 1%

Emergency dept visit, high/urgent complexity

$24.7M

32K claims · 11.1%

Your Cost: $782.52/claim|Median: $85.65
9.1× median
99282Top 1%

Emergency dept visit, low complexity

$8.6M

29K claims · 3.9%

Your Cost: $299.93/claim|Median: $37.72
8.0× median
0450Normal range

Emergency room visit

$6.6M

108K claims · 3.0%

Your Cost: $61.15/claim|Median: $44.95
1.4× median
80048Top 5%

Basic metabolic panel

$5.2M

111K claims · 2.4%

Your Cost: $47.08/claim|Median: $5.78
8.2× median
96374Top 10%

Therapeutic/prophylactic/diagnostic IV push, single substance

$3.9M

38K claims · 1.8%

Your Cost: $103.61/claim|Median: $21.76
4.8× median
96372Top 5%

Therapeutic injection, subcutaneous/intramuscular

$3.7M

60K claims · 1.7%

Your Cost: $61.48/claim|Median: $9.56
6.4× median
74177Top 25%

CT abdomen and pelvis with contrast

$2.9M

13K claims · 1.3%

Your Cost: $229.08/claim|Median: $65.76
3.5× median
J7030Top 5%

Normal saline solution infusion, 1000 cc

$2.8M

33K claims · 1.2%

Your Cost: $83.80/claim|Median: $1.53
54.8× median
Q9967Top 5%

Low osmolar contrast material, 300-399 mg iodine/ml, per ml

$2.7M

16K claims · 1.2%

Your Cost: $166.04/claim|Median: $3.42
48.5× median
80307Top 5%

Drug test, presumptive, by chemistry analyzers

$2.3M

19K claims · 1.0%

Your Cost: $121.00/claim|Median: $35.43
3.4× median
93005Top 25%

Electrocardiogram, tracing only, without interpretation

$2.2M

62K claims · 1.0%

Your Cost: $35.60/claim|Median: $7.50
4.8× median
0270Top 5%

$2.2M

31K claims · 1.0%

Your Cost: $70.85/claim|Median: $5.50
12.9× median
87426Top 1%

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$2.1M

28K claims · 1.0%

Your Cost: $77.08/claim|Median: $30.04
2.6× median
84484Top 5%

Troponin, quantitative

$1.9M

36K claims · 0.8%

Your Cost: $51.87/claim|Median: $4.84
10.7× median
71045Top 5%

Chest X-ray, single view

$1.9M

41K claims · 0.8%

Your Cost: $45.53/claim|Median: $4.93
9.2× median
70450Top 25%

CT head/brain without contrast

$1.8M

16K claims · 0.8%

Your Cost: $113.59/claim|Median: $45.53
2.5× median
Z7502Normal range

$1.7M

48K claims · 0.8%

Your Cost: $35.62/claim|Median: $37.17
1.0× median
94640Top 5%

Pressurized or nonpressurized inhalation treatment

$1.6M

17K claims · 0.7%

Your Cost: $96.34/claim|Median: $10.88
8.8× median
96361Normal range

IV infusion, hydration, each additional hour

$1.6M

32K claims · 0.7%

Your Cost: $50.70/claim|Median: $38.92
1.3× median
99281Top 25%

Emergency dept visit, minimal complexity

$1.6M

11K claims · 0.7%

Your Cost: $142.59/claim|Median: $52.03
2.7× median
G0378Top 25%

Hospital observation service, per hour

$1.5M

3K claims · 0.7%

Your Cost: $462.53/claim|Median: $99.39
4.7× median
81003Top 5%

Urinalysis, automated without microscopy

$1.5M

68K claims · 0.7%

Your Cost: $22.48/claim|Median: $1.48
15.2× median
81025Top 5%

Urine pregnancy test

$1.4M

59K claims · 0.7%

Your Cost: $24.61/claim|Median: $4.81
5.1× median
71046Top 5%

Chest X-ray, 2 views

$1.4M

22K claims · 0.6%

Your Cost: $66.38/claim|Median: $8.92
7.4× median
74176Top 25%

CT abdomen and pelvis without contrast

$1.4M

7K claims · 0.6%

Your Cost: $184.70/claim|Median: $60.19
3.1× median
0250Top 10%

$1.3M

21K claims · 0.6%

Your Cost: $60.72/claim|Median: $3.70
16.4× median
96375Top 25%

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$1.3M

30K claims · 0.6%

Your Cost: $43.02/claim|Median: $14.92
2.9× median
84702Top 1%

$1.3M

8K claims · 0.6%

Your Cost: $150.76/claim|Median: $8.25
18.3× median