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Use border differentials with state-level context, methodology, and graph relationships.
Guidance: How to interpret border pressure safely
← Medicaid hub · Intelligence dashboard · CA page · NV page
This tool does not predict payer actions. It highlights statistical variance patterns that may warrant clearer documentation.
Volume figures are aggregate counts, not individual claim predictions.
CA-NV border intelligence
How Medicaid patterns differ across the California / Nevada border
Compare aggregate differentials across 84 months and 93 codes to focus follow-up where border variation is highest.
These metrics measure statistical consistency, not clinical appropriateness.
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Avg abs paid/claim diff
132.5%
Max abs paid/claim diff
200.0%
Pressure score avg
83.8
30-mile ready rate
0.0%
Differential profile
This border is classified as state_border.
The current release observes 84 months and 93 codes.
Rows retained: 1,502 in the earlier release and 1,502 in the current release.
The average absolute claim-volume differential is 119.4%.
The average absolute paid-total differential is 144.2%.
The dominant inconsistency band is Review recommended with DQ sensitivity high.
Readiness and layer coverage
The maximum pressure score is 100.0 and the dominant priority tier is high.
Bilateral assignment status is proxy_v1_state_border_only.
Urban/rural layer status is pending_ruca_overlay.
Managed-care layer status is pending_plan_territory_overlay.
Top code signals by differential intensity
Ranked by average absolute paid-per-claim differential from the current border differential release.
| Code | Months observed | Avg abs paid/claim diff % | Max abs paid/claim diff % | Dominant band | Dominant DQ sensitivity |
|---|---|---|---|---|---|
| Q2035 | 1 | 200.0% | 200.0% | High review priority | high |
| 1220F | 2 | 200.0% | 200.0% | High review priority | high |
| 0003A | 1 | 200.0% | 200.0% | High review priority | high |
| 90611 | 1 | 200.0% | 200.0% | High review priority | high |
| 3016F | 4 | 200.0% | 200.0% | High review priority | high |
| 2023F | 13 | 200.0% | 200.0% | Review recommended | high |
| 1003F | 2 | 200.0% | 200.0% | High review priority | high |
| 1158F | 1 | 200.0% | 200.0% | Review recommended | high |
| 4037F | 3 | 200.0% | 200.0% | High review priority | high |
| 90660 | 1 | 200.0% | 200.0% | High review priority | high |
| G8979 | 14 | 200.0% | 200.0% | Review recommended | high |
| 4004F | 12 | 199.7% | 200.0% | Review recommended | high |
Metadata and limitations
- This border profile uses ID CA-NV.
- The release data package was generated 2026-03-21T18:33:23.950Z.
- Boundary outputs are aggregate statistical comparisons and do not attribute bilateral provider geocoordinates within 30 miles.
- Border differentials reflect proxy state-border context and should be interpreted with DQ sensitivity and readiness markers.
- State-border proxy (v1). No provider geocoordinates or 30-mile bilateral attribution in this release.
- Full 30-mile bilateral and territory overlays are scaffolded with readiness flags; provider geocoordinates and managed-care overlays are not yet applied.
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Page updated: 2026-02-16