County of Los Angeles
General Acute Care Hospital
Los Angeles, California
NPI: 1396756938
Risk Tier
High
Total Paid
$216.6M
$216,551,323
Total Claims
214K
Beneficiaries
169K
Avg Cost/Claim
$1,009.75
Active billing period: 82 months (2018-01 to 2024-10)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $1,003.08 per claim for T1015 (Clinic visit/encounter, all-inclusive), which is 8.3× the national median of $121.16.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: T1015 at 8.3× median, 00003 at 5.0× 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