Dallas County Hospital District
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $7.8M (2020) to $38.0M (2021) — a 388% swing with $30.2M absolute change.
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:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
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 $324.71 per claim for 99284 (Emergency dept visit, high complexity) — 4.7× the national median of $69.51.
Bills $268.04 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 3.1× the national median of $85.65.
Bills $46.72 per claim for 86850 — 8.6× the national median of $5.44.
Billing above the 90th percentile for 20 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center, Ambulatory Surgical Peers
Total spending distribution among 9 providers in this specialty
This provider's total spending of $152.6M is at the 75th percentile among 9 Clinic/Center, Ambulatory Surgical providers.
Total Paid
$152.6M
$152,600,083
Total Claims
3.3M
Beneficiaries
2.9M
1.1 claims/patient
Avg Cost/Claim
$46
#705 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
Dallas County Hospital District is a Clinic/Center, Ambulatory Surgical provider based in Dallas, TX. From the 2018–2024 period, this provider received $152.6M in Medicaid payments across 3.3M 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 $152.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,075 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 (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 14% of total spending.
$21.7M
202K claims
$107.53
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$21.7M
202K claims · 14.2%
$14.9M
205K claims
$72.71
$25.06
Office/outpatient visit, low complexity
$14.9M
205K claims · 9.8%
Injection, pembrolizumab, 1 mg
$11.7M
853 claims · 7.6%
$11.5M
36K claims
$324.71
$69.51
Emergency dept visit, high complexity
$11.5M
36K claims · 7.6%
$7.3M
97K claims
$75.00
$38.79
Infectious agent detection, amplified probe, multiple organisms
$7.3M
97K claims · 4.8%
$4.8M
33K claims
$145.09
$74.78
Ultrasound, pregnant uterus, complete, single fetus
$4.8M
33K claims · 3.2%
$4.4M
8K claims
$578.92
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$4.4M
8K claims · 2.9%
$4.1M
15K claims
$268.04
$85.65
Emergency dept visit, high/urgent complexity
$4.1M
15K claims · 2.7%
$3.3M
30K claims
$109.01
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$3.3M
30K claims · 2.2%
$2.7M
57K claims · 1.7%
$2.6M
95K claims
$27.34
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$2.6M
95K claims · 1.7%
CT abdomen and pelvis with contrast
$2.0M
6K claims · 1.3%
$1.9M
28K claims
$67.40
$7.50
Electrocardiogram, tracing only, without interpretation
$1.9M
28K claims · 1.3%
$1.8M
33K claims
$53.87
$42.48
Emergency dept visit, moderate complexity
$1.8M
33K claims · 1.2%
$1.6M
13K claims
$129.38
$58.55
Ultrasound, pregnant uterus, follow-up
$1.6M
13K claims · 1.1%
$1.5M
57K claims
$26.59
$9.80
Immunization administration, 1 vaccine, percutaneous/ID/SC/IM
$1.5M
57K claims · 1.0%
$1.5M
29K claims
$50.76
$12.93
Office/outpatient visit, minimal complexity
$1.5M
29K claims · 1.0%
$1.4M
92K claims · 0.9%
$1.4M
4K claims
$383.09
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.4M
4K claims · 0.9%
$1.2M
12K claims
$98.34
$84.03
Office/outpatient visit, new patient, mod-high complexity
$1.2M
12K claims · 0.8%
$1.1M
16K claims
$73.37
$63.08
Infectious disease detection (COVID-19)
$1.1M
16K claims · 0.7%
Injection, bevacizumab, 10 mg
$996K
278 claims · 0.7%
$950K
42K claims · 0.6%
$922K
6K claims
$153.44
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$922K
6K claims · 0.6%
$796K
7K claims
$119.82
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$796K
7K claims · 0.5%
$783K
7K claims
$106.09
$38.92
IV infusion, hydration, each additional hour
$783K
7K claims · 0.5%
Tdap vaccine
$769K
23K claims · 0.5%
Comprehensive metabolic panel
$764K
63K claims · 0.5%
$750K
32K claims · 0.5%
Therapeutic exercises, each 15 min
$744K
9K claims · 0.5%
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