County of Stanislaus
New Entrant
Started billing recently but already receiving millions in Medicaid payments.
First appeared in 2023-07 and has already billed $63.5M, averaging $3.7M/month across 17 months.
Instant Volume
New provider billing over $1M in their first year of Medicaid participation.
Billed $25.6M in first year (2023).
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:
New Entrant
New Entrant means this provider began billing Medicaid recently but is already receiving millions of dollars in payments. While some new providers legitimately grow fast (e.g., large group practices), this pattern is also common in fraud schemes that set up shell companies to bill aggressively before shutting down.
Instant Volume
Instant Volume means this provider billed over $1 million in their very first year of Medicaid participation. New providers typically ramp up gradually, so immediate high-volume billing can be a red flag.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Community/Behavioral Health Peers
Total spending distribution among 218 providers in this specialty
This provider's total spending of $63.5M is at the 50th percentile among 218 Community/Behavioral Health providers.
Total Paid
$63.5M
$63,544,673
Total Claims
196K
Beneficiaries
101K
1.9 claims/patient
Avg Cost/Claim
$324
🔍 Analysis
Provider Overview
County of Stanislaus is a Community/Behavioral Health provider based in Modesto, CA. From the 2018–2024 period, this provider received $63.5M in Medicaid payments across 196K 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
At $63.5M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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