County of Los Angeles
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,003.08 per claim for T1015 (Clinic visit/encounter, all-inclusive), which is 8.3× the national median of $121.16.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: T1015 at 8.3× median, 00003 at 5.0× 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:
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.
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 $1,003.08 per claim for T1015 (Clinic visit/encounter, all-inclusive) — 8.3× the national median of $121.16.
Bills $1,109.14 per claim for 00003 (Anesthesia services) — 5.0× the national median of $223.77.
Bills $258.68 per claim for G0467 (Federally qualified health center visit, mental health) — 11.8× the national median of $21.91.
Billing in the top 1% nationally for 2 procedure codes: T1015, 00003.
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 $216.6M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$216.6M
$216,551,323
Total Claims
214K
Beneficiaries
169K
1.3 claims/patient
Avg Cost/Claim
$1K
#400 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
County of Los Angeles is a General Acute Care Hospital provider based in Los Angeles, CA. From the 2018–2024 period, this provider received $216.6M in Medicaid payments across 214K 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
This provider received $216.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,068 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 3 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 78% of total spending.
$167.9M
167K claims
$1,003.08
$121.16
Clinic visit/encounter, all-inclusive
$167.9M
167K claims · 77.5%
Anesthesia services
$47.5M
43K claims · 22.0%
$1.1M
4K claims
$258.68
$21.91
Federally qualified health center visit, mental health
$1.1M
4K claims · 0.5%
Other Top Providers in California
View all →Los Angeles County Department of Mental Health
Clinic/Center, Mental Health (Including Community
$6.78B
County of Santa Clara
Community/Behavioral Health
$1.73B
County of Riverside
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$1.40B
City & County of San Francisco
Community/Behavioral Health
$1.34B
Los Angeles County Department of Public Health
Public Health or Welfare
$1.13B
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