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

⚖️ Compare🖨️ Print Report

VALLEY CHILDREN'S HOSPITAL

General Acute Care Hospital, Children·MADERA, CA·NPI: 1700949336Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$107.1M

$107,109,939

Total Claims

2.8M

Beneficiaries

2.6M

1.1 claims/patient

Avg Cost/Claim

$38

Monthly Spending Trend

Yearly Spending

2018
$18.5M
-13%
2019
$16.1M
-31%
2020
$11.1M
+30%
2021
$14.4M
+11%
2022
$16.0M
+5%
2023
$16.7M
-15%
2024
$14.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (0360) accounts for 11% of total spending.

0360Top 10%

$11.6M

18K claims · 10.8%

Your Cost: $628.19/claim|Median: $95.40
6.6× median
0450Normal range

Emergency room visit

$10.4M

285K claims · 9.7%

Your Cost: $36.45/claim|Median: $44.95
0.8× median
Z7500Normal range

$5.2M

154K claims · 4.9%

Your Cost: $33.87/claim|Median: $33.71
1.0× median
99211Top 10%

Office/outpatient visit, minimal complexity

$4.8M

80K claims · 4.4%

Your Cost: $59.33/claim|Median: $12.93
4.6× median
0710Top 5%

$3.8M

17K claims · 3.6%

Your Cost: $220.97/claim|Median: $18.49
12.0× median
99213Top 5%

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

$3.7M

25K claims · 3.4%

Your Cost: $146.63/claim|Median: $37.81
3.9× median
70553Top 5%

MRI brain without contrast, then with contrast

$3.1M

2,967 claims · 2.9%

Your Cost: $1,045.21/claim|Median: $133.68
7.8× median
99281Normal range

Emergency dept visit, minimal complexity

$2.6M

31K claims · 2.4%

Your Cost: $84.21/claim|Median: $52.03
1.6× median
70551Top 5%

MRI brain without contrast

$2.3M

4,202 claims · 2.2%

Your Cost: $552.08/claim|Median: $85.39
6.5× median
G0463Normal range

Hospital outpatient clinic visit

$1.8M

31K claims · 1.7%

Your Cost: $57.74/claim|Median: $26.41
2.2× median
V5298Normal range

$1.8M

1,435 claims · 1.7%

Your Cost: $1,233.69/claim|Median: $1,373.37
0.9× median
U0003Normal range

Infectious disease detection (COVID-19)

$1.7M

43K claims · 1.6%

Your Cost: $40.17/claim|Median: $63.08
0.6× median
Z7506Normal range

$1.6M

13K claims · 1.5%

Your Cost: $120.98/claim|Median: $120.98
1.0× median
93325Top 5%

$1.6M

15K claims · 1.5%

Your Cost: $104.89/claim|Median: $14.61
7.2× median
0510Top 10%

Revenue code, clinic services

$1.5M

20K claims · 1.4%

Your Cost: $75.00/claim|Median: $28.38
2.6× median
99285Top 5%

Emergency dept visit, high/urgent complexity

$1.5M

3,021 claims · 1.4%

Your Cost: $498.38/claim|Median: $85.65
5.8× median
99283Top 1%

Emergency dept visit, moderate complexity

$1.5M

2,425 claims · 1.4%

Your Cost: $599.35/claim|Median: $42.48
14.1× median
42820Normal range

Tonsillectomy and adenoidectomy, under age 12

$1.4M

3,478 claims · 1.3%

Your Cost: $413.80/claim|Median: $331.68
1.2× median
95810Top 25%

Polysomnography, sleep study, 6+ hours

$1.3M

2,641 claims · 1.2%

Your Cost: $486.64/claim|Median: $233.73
2.1× median
95782Top 25%

$1.1M

1,034 claims · 1.1%

Your Cost: $1,104.96/claim|Median: $216.35
5.1× median
99215Top 10%

Office/outpatient visit, high complexity

$1.1M

6,961 claims · 1.0%

Your Cost: $156.82/claim|Median: $74.09
2.1× median
76770Top 25%

Ultrasound, retroperitoneal, complete

$1.1M

12K claims · 1.0%

Your Cost: $85.23/claim|Median: $37.35
2.3× median
0760Normal range

$1.0M

122K claims · 0.9%

Your Cost: $8.23/claim|Median: $22.01
0.4× median
80053Normal range

Comprehensive metabolic panel

$902K

93K claims · 0.8%

Your Cost: $9.73/claim|Median: $7.24
1.3× median
99214Normal range

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

$866K

12K claims · 0.8%

Your Cost: $75.13/claim|Median: $53.41
1.4× median
Z4300Normal range

$865K

8,396 claims · 0.8%

Your Cost: $102.99/claim|Median: $72.00
1.4× median
Z7502Normal range

$849K

23K claims · 0.8%

Your Cost: $36.62/claim|Median: $37.17
1.0× median
J0586Normal range

$849K

1,790 claims · 0.8%

Your Cost: $474.03/claim|Median: $667.48
0.7× median
92567Top 5%

$767K

12K claims · 0.7%

Your Cost: $63.69/claim|Median: $11.50
5.5× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$749K

87K claims · 0.7%

Your Cost: $8.59/claim|Median: $4.71
1.8× median
S0302Top 5%

$723K

7,038 claims · 0.7%

Your Cost: $102.67/claim|Median: $9.05
11.3× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$717K

343 claims · 0.7%

Your Cost: $2,090.09/claim|Median: $1,587.53
1.3× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$687K

9,273 claims · 0.6%

Your Cost: $74.13/claim|Median: $106.79
0.7× median
92557Top 5%

Comprehensive audiometry, air, bone, and speech testing

$675K

5,054 claims · 0.6%

Your Cost: $133.50/claim|Median: $27.28
4.9× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$620K

3,347 claims · 0.6%

Your Cost: $185.15/claim|Median: $54.68
3.4× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$619K

16K claims · 0.6%

Your Cost: $38.52/claim|Median: $58.55
0.7× median
0761Normal range

$566K

38K claims · 0.5%

Your Cost: $14.72/claim|Median: $24.10
0.6× median
69436Normal range

Tympanostomy, general anesthesia

$555K

2,005 claims · 0.5%

Your Cost: $276.62/claim|Median: $205.50
1.3× median
43239Top 25%

Upper GI endoscopy with biopsy

$548K

1,259 claims · 0.5%

Your Cost: $435.62/claim|Median: $151.68
2.9× median
Z4304Top 10%

$545K

7,052 claims · 0.5%

Your Cost: $77.23/claim|Median: $53.44
1.4× median
72148Top 5%

MRI lumbar spine without contrast

$534K

894 claims · 0.5%

Your Cost: $596.76/claim|Median: $101.03
5.9× median
93304Normal range

$509K

7,207 claims · 0.5%

Your Cost: $70.64/claim|Median: $54.29
1.3× median
Q3014Top 10%

Telehealth originating site facility fee

$507K

16K claims · 0.5%

Your Cost: $31.43/claim|Median: $15.37
2.0× median
73721Top 10%

MRI joint of lower extremity without contrast

$499K

1,318 claims · 0.5%

Your Cost: $378.80/claim|Median: $127.34
3.0× median
Q5103Top 25%

$478K

222 claims · 0.4%

Your Cost: $2,152.83/claim|Median: $1,075.28
2.0× median
Z4301Normal range

$435K

17K claims · 0.4%

Your Cost: $25.64/claim|Median: $24.01
1.1× median
Z7610Top 1%

$425K

23K claims · 0.4%

Your Cost: $18.67/claim|Median: $9.46
2.0× median
76705Normal range

Ultrasound, abdominal, limited

$419K

14K claims · 0.4%

Your Cost: $30.00/claim|Median: $23.81
1.3× median
70450Top 25%

CT head/brain without contrast

$403K

4,201 claims · 0.4%

Your Cost: $95.98/claim|Median: $45.53
2.1× median
L8699Normal range

Prosthetic implant, not otherwise classified

$403K

697 claims · 0.4%

Your Cost: $578.09/claim|Median: $389.88
1.5× 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 →