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

⚖️ Compare🖨️ Print Report

LPCH MEDICAL GROUP DIV OF LUCILE

General Acute Care Hospital, Children·PALO ALTO, CA·NPI: 1417907940Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$41.0M

$40,984,273

Total Claims

720K

Beneficiaries

622K

1.2 claims/patient

Avg Cost/Claim

$57

Monthly Spending Trend

Yearly Spending

2018
$5.0M
+6%
2019
$5.3M
-15%
2020
$4.5M
+31%
2021
$5.9M
+2%
2022
$6.0M
+23%
2023
$7.3M
-3%
2024
$7.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99215 (Office/outpatient visit, high complexity)) accounts for 20% of total spending.

99215Top 25%

Office/outpatient visit, high complexity

$8.1M

62K claims · 19.8%

Your Cost: $130.58/claim|Median: $74.09
1.8× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$5.9M

88K claims · 14.5%

Your Cost: $67.44/claim|Median: $53.41
1.3× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$3.2M

90K claims · 7.8%

Your Cost: $35.50/claim|Median: $37.81
0.9× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$2.3M

15K claims · 5.7%

Your Cost: $161.06/claim|Median: $54.68
2.9× median
93303Normal range

Echocardiography, transthoracic, limited

$2.2M

18K claims · 5.4%

Your Cost: $123.42/claim|Median: $112.83
1.1× median
99233Top 10%

Subsequent hospital care, per day, high complexity

$1.7M

23K claims · 4.1%

Your Cost: $73.00/claim|Median: $35.30
2.1× median
99244Top 25%

Office or other outpatient consultation, moderate complexity

$1.5M

9,529 claims · 3.7%

Your Cost: $158.58/claim|Median: $121.58
1.3× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$1.3M

8,601 claims · 3.1%

Your Cost: $145.74/claim|Median: $106.79
1.4× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$1.2M

17K claims · 3.0%

Your Cost: $70.45/claim|Median: $58.55
1.2× median
93320Top 25%

$943K

19K claims · 2.3%

Your Cost: $49.15/claim|Median: $28.68
1.7× median
93325Normal range

$817K

28K claims · 2.0%

Your Cost: $28.86/claim|Median: $14.61
2.0× median
99291Top 10%

Critical care, first 30-74 minutes

$686K

3,167 claims · 1.7%

Your Cost: $216.71/claim|Median: $101.24
2.1× median
99203Top 25%

Office/outpatient visit, new patient, low-mod complexity

$663K

7,527 claims · 1.6%

Your Cost: $88.15/claim|Median: $57.85
1.5× median
70553Normal range

MRI brain without contrast, then with contrast

$572K

4,803 claims · 1.4%

Your Cost: $119.01/claim|Median: $133.68
0.9× median
71045Top 25%

Chest X-ray, single view

$572K

60K claims · 1.4%

Your Cost: $9.45/claim|Median: $4.93
1.9× median
70551Normal range

MRI brain without contrast

$506K

6,907 claims · 1.2%

Your Cost: $73.32/claim|Median: $85.39
0.9× median
93010Top 5%

Electrocardiogram, interpretation and report only

$472K

34K claims · 1.2%

Your Cost: $13.77/claim|Median: $5.60
2.5× median
76813Normal range

Ultrasound for fetal nuchal translucency measurement

$449K

5,670 claims · 1.1%

Your Cost: $79.14/claim|Median: $70.87
1.1× median
99232Top 5%

Subsequent hospital care, per day, moderate complexity

$397K

6,561 claims · 1.0%

Your Cost: $60.45/claim|Median: $23.99
2.5× median
99243Normal range

Office or other outpatient consultation, low complexity

$374K

3,933 claims · 0.9%

Your Cost: $95.12/claim|Median: $82.43
1.2× median
93000Top 10%

Electrocardiogram, complete, with interpretation and report

$367K

17K claims · 0.9%

Your Cost: $21.89/claim|Median: $9.70
2.3× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$357K

5,961 claims · 0.9%

Your Cost: $59.95/claim|Median: $62.48
1.0× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$354K

1,879 claims · 0.9%

Your Cost: $188.52/claim|Median: $233.73
0.8× median
76770Top 25%

Ultrasound, retroperitoneal, complete

$309K

4,015 claims · 0.8%

Your Cost: $76.95/claim|Median: $37.35
2.1× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$299K

2,561 claims · 0.7%

Your Cost: $116.93/claim|Median: $84.03
1.4× median
95720Top 10%

$281K

1,257 claims · 0.7%

Your Cost: $223.45/claim|Median: $120.95
1.8× median
76825Top 25%

$267K

1,279 claims · 0.7%

Your Cost: $209.10/claim|Median: $103.74
2.0× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$259K

5,334 claims · 0.6%

Your Cost: $48.65/claim|Median: $37.22
1.3× median
99417Normal range

$257K

4,556 claims · 0.6%

Your Cost: $56.41/claim|Median: $34.90
1.6× median
99205Top 25%

Office/outpatient visit, new patient, high complexity

$256K

1,537 claims · 0.6%

Your Cost: $166.36/claim|Median: $111.09
1.5× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$245K

2,914 claims · 0.6%

Your Cost: $83.92/claim|Median: $74.78
1.1× median
99245Top 25%

Office consultation, high complexity

$237K

1,310 claims · 0.6%

Your Cost: $180.54/claim|Median: $143.30
1.3× median
76815Normal range

Ultrasound, pregnant uterus, limited

$175K

6,030 claims · 0.4%

Your Cost: $29.02/claim|Median: $36.79
0.8× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$147K

22K claims · 0.4%

Your Cost: $6.68/claim|Median: $17.85
0.4× median
95951Normal range

$133K

510 claims · 0.3%

Your Cost: $260.68/claim|Median: $183.28
1.4× median
74018Normal range

$130K

13K claims · 0.3%

Your Cost: $10.21/claim|Median: $7.00
1.5× median
01967Normal range

Anesthesia, neuraxial labor analgesia/delivery

$125K

417 claims · 0.3%

Your Cost: $299.88/claim|Median: $283.78
1.1× median
59025Normal range

Fetal non-stress test

$116K

8,395 claims · 0.3%

Your Cost: $13.78/claim|Median: $26.45
0.5× median
99242Top 25%

Office consultation, low complexity

$92K

1,200 claims · 0.2%

Your Cost: $76.95/claim|Median: $57.97
1.3× median
76827Top 25%

$91K

1,334 claims · 0.2%

Your Cost: $68.15/claim|Median: $39.58
1.7× median
99480Top 10%

Subsequent intensive care, very low birth weight infant

$90K

687 claims · 0.2%

Your Cost: $130.57/claim|Median: $98.15
1.3× median
99462Normal range

$88K

2,796 claims · 0.2%

Your Cost: $31.45/claim|Median: $27.49
1.1× median
96112Normal range

Developmental test administration

$78K

519 claims · 0.2%

Your Cost: $150.86/claim|Median: $102.95
1.5× median
69210Top 25%

$69K

1,901 claims · 0.2%

Your Cost: $36.44/claim|Median: $21.74
1.7× median
31645Top 5%

$66K

443 claims · 0.2%

Your Cost: $148.67/claim|Median: $57.36
2.6× median
99392Normal range

Preventive medicine, established patient, age 1-4

$64K

1,974 claims · 0.2%

Your Cost: $32.49/claim|Median: $75.18
0.4× median
S0302Top 25%

$63K

1,975 claims · 0.2%

Your Cost: $31.76/claim|Median: $9.05
3.5× median
99472Normal range

Subsequent pediatric critical care, per day, age 2-5

$60K

264 claims · 0.1%

Your Cost: $228.33/claim|Median: $307.98
0.7× median
72082Normal range

$58K

1,600 claims · 0.1%

Your Cost: $36.54/claim|Median: $31.02
1.2× median
99231Top 10%

Subsequent hospital care, per day, low complexity

$58K

1,536 claims · 0.1%

Your Cost: $37.96/claim|Median: $16.77
2.3× median

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

Community/Behavioral Health

$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

Similar Providers

Other top providers in General Acute Care Hospital, Children

Dayton Children's Hospital

Dayton, OH

$290.6M

Connecticut Children's Medical Center

Hartford, CT

$248.9M

← All providersAll providers in California →How we detect fraud →