Los Angeles County Department of Public Health
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 7 procedure codes: T1007 at 4.7× median, H0001 at 5.0× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
Spending Spike
Experienced a dramatic increase in billing over a short period.
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:
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.
Unusually High Spending
Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.
Spending Spike
Spending Spike means this provider experienced a dramatic, sudden increase in billing over a short period. Legitimate causes include new contracts or expanded services, but this pattern also appears in billing fraud ramp-ups.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $299.20 per claim for T1007 (Alcohol/drug services, treatment plan review) — 4.7× the national median of $64.10.
Bills $469.07 per claim for H0001 (Alcohol and/or drug assessment) — 5.0× the national median of $94.22.
Bills $30.53 per claim for S5000 (Prescription drug, generic) — 4.1× the national median of $7.47.
Billing in the top 1% nationally for 2 procedure codes: H0001, H0048.
This is a statistical summary, not an accusation. See our methodology.
Compared to Public Health or Welfare Peers
Total spending distribution among 17 providers in this specialty
This provider's total spending of $1.13B is at the 75th percentile among 17 Public Health or Welfare providers.
Total Paid
$1.13B
$1,125,938,944
Total Claims
15.0M
Beneficiaries
1.5M
9.8 claims/patient
Avg Cost/Claim
$75
#22 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Los Angeles County Department of Public Health is a Public Health or Welfare provider based in Alhambra, CA. From the 2018–2024 period, this provider received $1.1B in Medicaid payments across 15.0M 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 $1.1B in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 140,742 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 30 distinct procedure codes. The top code (H0019 (Behavioral health; residential, per diem)) accounts for 49% of total spending.
$554.0M
2.9M claims
$192.05
$357.16
Behavioral health; residential, per diem
$554.0M
2.9M claims · 49.2%
$188.2M
1.6M claims
$119.73
$74.63
Behavioral health counseling & therapy, per 15 min
$188.2M
1.6M claims · 16.7%
$108.5M
1.6M claims
$66.81
$47.35
Alcohol and/or drug services, group counseling
$108.5M
1.6M claims · 9.6%
$103.1M
7.0M claims
$14.68
$18.95
Alcohol/drug services; methadone administration
$103.1M
7.0M claims · 9.2%
$88.0M
1.2M claims
$75.49
$43.10
Alcohol and/or drug services, case management
$88.0M
1.2M claims · 7.8%
$35.1M
115K claims · 3.1%
$28.8M
471K claims
$61.23
$129.75
Alcohol and/or drug abuse, intensive outpatient, per hour
$28.8M
471K claims · 2.6%
$5.3M
18K claims
$299.20
$64.10
Alcohol/drug services, treatment plan review
$5.3M
18K claims · 0.5%
$4.7M
38K claims
$123.39
$69.56
Targeted case management, per 15 min
$4.7M
38K claims · 0.4%
Alcohol and/or drug assessment
$4.0M
9K claims · 0.4%
$1.2M
7K claims
$177.09
$96.24
Comprehensive community support services, per 15 min
$1.2M
7K claims · 0.1%
$1.1M
11K claims
$102.41
$83.88
Skills training & development, per 15 min
$1.1M
11K claims · 0.1%
$901K
11K claims · 0.1%
Prescription drug, generic
$836K
27K claims · 0.1%
$678K
3K claims
$224.21
$91.63
Psychosocial rehabilitation services, per 15 min
$678K
3K claims · 0.1%
$277K
719 claims · 0.0%
$228K
11K claims
$20.06
$36.25
Behavioral health prevention education, per session
$228K
11K claims · 0.0%
$188K
1K claims
$143.42
$55.04
Self-help/peer services, per 15 minutes
$188K
1K claims · 0.0%
$151K
836 claims
$180.98
$109.04
Alcohol/drug services, family/couple counseling
$151K
836 claims · 0.0%
$134K
2K claims · 0.0%
$125K
684 claims
$182.79
$40.78
Alcohol/drug services, skills development
$125K
684 claims · 0.0%
$107K
499 claims
$214.24
$62.69
Comprehensive medication services, per 15 min
$107K
499 claims · 0.0%
$69K
594 claims
$115.57
$31.37
Oral medication administration, direct observation
$69K
594 claims · 0.0%
$57K
188 claims
$304.41
$56.90
Medication training and management, per 15 min
$57K
188 claims · 0.0%
$50K
163 claims
$305.08
$82.72
Psychoeducational service, per 15 minutes
$50K
163 claims · 0.0%
$22K
297 claims · 0.0%
$9K
31 claims · 0.0%
$5K
45 claims · 0.0%
Psychiatric diagnostic evaluation
$2K
38 claims · 0.0%
Patient-focused health risk assessment
$307
63 claims · 0.0%
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
Alameda County Behavioral Health Care
Community/Behavioral Health
$1.07B
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