Loma Linda University Children's Hospital
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $826.76 per claim for 99283 (Emergency dept visit, moderate complexity), which is 19.5× the national median of $42.48.
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.
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 Children Peers
Total spending distribution among 16 providers in this specialty
This provider's total spending of $107.1M is at the 25th percentile among 16 General Acute Care Hospital Children providers.
Total Paid
$107.1M
$107,098,821
Total Claims
1.3M
Beneficiaries
1.0M
1.2 claims/patient
Avg Cost/Claim
$85
🔍 Analysis
Provider Overview
Loma Linda University Children's Hospital is a General Acute Care Hospital Children provider based in Loma Linda, CA. From the 2018–2024 period, this provider received $107.1M in Medicaid payments across 1.3M claims.
Why This Matters
This provider received $107.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 13,387 Medicaid beneficiaries for a full year at average per-enrollee costs.
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