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

Contra Costa County

General Acute Care Hospital

Martinez, California

NPI: 1427138726

Risk Tier

High

Total Paid

$537.0M

$536,975,608

Total Claims

3.2M

Beneficiaries

635K

Avg Cost/Claim

$168.94

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (2)

Cost Outlier

Billing over 3× the national median for specific procedure codes.

Bills $322.45 per claim for H2017 (Psychosocial rehabilitation services, per 15 min), which is 3.5× the national median of $91.63.

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 43 procedure codes: H2017 at 3.5× median, H2019 at 4.8× median.

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