Yuma Regional Medical Center
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 130 procedure codes: 99284 at 4.5× median, 99211 at 5.0× median.
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.
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 $309.93 per claim for 99284 (Emergency dept visit, high complexity) — 4.5× the national median of $69.51.
Bills $64.88 per claim for 99211 (Office/outpatient visit, minimal complexity) — 5.0× the national median of $12.93.
Bills $245.70 per claim for 99283 (Emergency dept visit, moderate complexity) — 5.8× the national median of $42.48.
Billing in the top 1% nationally for 3 procedure codes: 99285, 90460, 95004.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $278.4M is at the 75th percentile among 156 General Acute Care Hospital providers.
Total Paid
$278.4M
$278,420,283
Total Claims
6.9M
Beneficiaries
5.7M
1.2 claims/patient
Avg Cost/Claim
$40
#280 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Yuma Regional Medical Center is a General Acute Care Hospital provider based in Yuma, AZ. From the 2018–2024 period, this provider received $278.4M in Medicaid payments across 6.9M claims.
Why This Matters
This provider received $278.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 34,802 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 (99284 (Emergency dept visit, high complexity)) accounts for 10% of total spending.
$26.6M
86K claims
$309.93
$69.51
Emergency dept visit, high complexity
$26.6M
86K claims · 9.6%
$25.3M
391K claims
$64.88
$12.93
Office/outpatient visit, minimal complexity
$25.3M
391K claims · 9.1%
$23.3M
95K claims
$245.70
$42.48
Emergency dept visit, moderate complexity
$23.3M
95K claims · 8.4%
$13.4M
23K claims
$583.66
$85.65
Emergency dept visit, high/urgent complexity
$13.4M
23K claims · 4.8%
CT abdomen and pelvis with contrast
$13.1M
33K claims · 4.7%
$8.0M
170K claims
$47.24
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$8.0M
170K claims · 2.9%
$7.4M
18K claims
$423.53
$121.16
Clinic visit/encounter, all-inclusive
$7.4M
18K claims · 2.7%
$6.9M
193K claims
$35.75
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$6.9M
193K claims · 2.5%
$5.3M
27K claims
$191.70
$36.13
Debridement, subcutaneous tissue, first 20 sq cm
$5.3M
27K claims · 1.9%
$4.6M
1K claims · 1.7%
Injection, pembrolizumab, 1 mg
$4.3M
501 claims · 1.5%
Emergency dept visit, low complexity
$4.2M
24K claims · 1.5%
$4.1M
13K claims
$317.20
$60.19
CT abdomen and pelvis without contrast
$4.1M
13K claims · 1.5%
$3.7M
41K claims
$88.94
$39.33
Screening mammography, bilateral, including CAD
$3.7M
41K claims · 1.3%
$3.3M
877 claims
$3,797.06
$331.68
Tonsillectomy and adenoidectomy, under age 12
$3.3M
877 claims · 1.2%
Upper GI endoscopy with biopsy
$3.2M
13K claims · 1.2%
Colonoscopy with biopsy
$3.0M
5K claims · 1.1%
$2.8M
45K claims
$62.59
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$2.8M
45K claims · 1.0%
$2.6M
866 claims
$3,013.73
$1,115.75
Total knee replacement surgery, both components
$2.6M
866 claims · 0.9%
$2.5M
527 claims · 0.9%
Ultrasound, pelvic, complete
$2.4M
21K claims · 0.9%
$2.2M
6K claims
$348.61
$255.17
Colonoscopy with polyp removal, snare technique
$2.2M
6K claims · 0.8%
$2.2M
1K claims
$1,559.21
$183.33
Left heart catheterization with imaging
$2.2M
1K claims · 0.8%
$1.9M
10K claims
$195.22
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.9M
10K claims · 0.7%
$1.9M
31K claims
$60.49
$17.85
Immunization administration, first vaccine/toxoid, with counseling
$1.9M
31K claims · 0.7%
$1.8M
59K claims
$31.14
$40.11
Office/outpatient visit, new patient, low complexity
$1.8M
59K claims · 0.7%
CT head/brain without contrast
$1.7M
33K claims · 0.6%
$1.7M
317 claims · 0.6%
Colonoscopy, diagnostic
$1.7M
3K claims · 0.6%
Percutaneous allergy skin tests, each
$1.7M
2K claims · 0.6%
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