County of Ventura
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 33 procedure codes: H0032 at 3.2× median, S9484 at 11.0× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
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.
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $280.85 per claim for H2010 (Comprehensive medication services, per 15 min) — 4.5× the national median of $62.69.
Bills $184.60 per claim for H0034 (Medication training and management, per 15 min) — 3.2× the national median of $56.90.
Bills $68.51 per claim for H0020 (Alcohol/drug services; methadone administration) — 3.6× the national median of $18.95.
Billing in the top 1% nationally for 8 procedure codes: 90837, 99214, 99215.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community/Behavioral Health Peers
Total spending distribution among 218 providers in this specialty
This provider's total spending of $598.2M is at the 90th percentile among 218 Community/Behavioral Health providers.
Above 90th percentile for this specialty — higher spending than 196 of 218 peers
Total Paid
$598.2M
$598,198,692
Total Claims
3.1M
Beneficiaries
1.1M
2.9 claims/patient
Avg Cost/Claim
$192
#92 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
County of Ventura is a Community/Behavioral Health provider based in Oxnard, CA. From the 2018–2024 period, this provider received $598.2M in Medicaid payments across 3.1M 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 $598.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 74,774 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 (H2015 (Comprehensive community support services, per 15 min)) accounts for 26% of total spending.
$154.7M
585K claims
$264.53
$96.24
Comprehensive community support services, per 15 min
$154.7M
585K claims · 25.9%
$72.3M
473K claims
$152.77
$69.56
Targeted case management, per 15 min
$72.3M
473K claims · 12.1%
$53.8M
192K claims
$280.85
$62.69
Comprehensive medication services, per 15 min
$53.8M
192K claims · 9.0%
$51.7M
190K claims
$272.52
$357.16
Behavioral health; residential, per diem
$51.7M
190K claims · 8.6%
$44.8M
243K claims
$184.60
$56.90
Medication training and management, per 15 min
$44.8M
243K claims · 7.5%
$37.8M
290K claims
$130.24
$91.63
Psychosocial rehabilitation services, per 15 min
$37.8M
290K claims · 6.3%
$31.9M
466K claims
$68.51
$18.95
Alcohol/drug services; methadone administration
$31.9M
466K claims · 5.3%
$24.6M
249K claims
$98.80
$74.63
Behavioral health counseling & therapy, per 15 min
$24.6M
249K claims · 4.1%
$21.2M
83K claims
$255.55
$80.64
Mental health service plan development
$21.2M
83K claims · 3.5%
$15.7M
6K claims
$2,753.54
$249.51
Crisis intervention mental health services, per hour
$15.7M
6K claims · 2.6%
$15.4M
37K claims
$418.73
$467.51
Behavioral health; short-term residential, per diem
$15.4M
37K claims · 2.6%
$13.4M
47K claims
$287.74
$84.12
Therapeutic behavioral services, per 15 min
$13.4M
47K claims · 2.2%
$9.4M
15K claims
$609.64
$215.80
Crisis intervention service, per 15 minutes
$9.4M
15K claims · 1.6%
Psychotherapy, 60 minutes
$8.5M
26K claims · 1.4%
$7.8M
13K claims
$600.98
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$7.8M
13K claims · 1.3%
Psychotherapy, 45 minutes
$5.2M
20K claims · 0.9%
$4.7M
6K claims
$838.86
$74.09
Office/outpatient visit, high complexity
$4.7M
6K claims · 0.8%
$2.9M
17K claims
$167.69
$72.96
Prolonged office/outpatient E/M, each additional 15 min
$2.9M
17K claims · 0.5%
$2.8M
10K claims · 0.5%
Psychotherapy, 30 minutes
$2.6M
16K claims · 0.4%
$2.5M
7K claims
$386.91
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$2.5M
7K claims · 0.4%
$2.3M
3K claims
$856.61
$23.99
Subsequent hospital care, per day, moderate complexity
$2.3M
3K claims · 0.4%
Prescription drug, generic
$1.9M
62K claims · 0.3%
$1.4M
15K claims
$95.37
$43.10
Alcohol and/or drug services, case management
$1.4M
15K claims · 0.2%
$1.0M
806 claims
$1,269.98
$111.09
Office/outpatient visit, new patient, high complexity
$1.0M
806 claims · 0.2%
$927K
3K claims
$289.35
$77.33
Family psychotherapy with patient, 50 min
$927K
3K claims · 0.2%
$899K
4K claims
$239.56
$25.06
Office/outpatient visit, low complexity
$899K
4K claims · 0.2%
$638K
8K claims
$79.19
$47.35
Alcohol and/or drug services, group counseling
$638K
8K claims · 0.1%
$584K
1K claims
$578.19
$16.77
Subsequent hospital care, per day, low complexity
$584K
1K claims · 0.1%
$534K
5K claims
$104.43
$99.21
Psychiatric diagnostic evaluation
$534K
5K claims · 0.1%
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