Chapa-de Indian Health Program Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $539.90 per claim for T1015 (Clinic visit/encounter, all-inclusive), which is 4.5× the national median of $121.16.
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $539.90 per claim for T1015 (Clinic visit/encounter, all-inclusive) — 4.5× the national median of $121.16.
Bills $307.18 per claim for G0467 (Federally qualified health center visit, mental health) — 14.0× the national median of $21.91.
Bills $302.92 per claim for G0470 (Chronic care management services, FQHC/RHC) — 6.6× the national median of $45.95.
Billing in the top 1% nationally for 2 procedure codes: 92014, 92004.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center Federally Qualified Health Center (FQHC) Peers
Total spending distribution among 24 providers in this specialty
This provider's total spending of $129.6M is at the 50th percentile among 24 Clinic/Center Federally Qualified Health Center (FQHC) providers.
Total Paid
$129.6M
$129,569,368
Total Claims
431K
Beneficiaries
345K
1.3 claims/patient
Avg Cost/Claim
$300
#893 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
Chapa-de Indian Health Program Inc. is a Clinic/Center Federally Qualified Health Center (FQHC) provider based in Auburn, CA. From the 2018–2024 period, this provider received $129.6M in Medicaid payments across 431K claims.
Why This Matters
This provider received $129.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,196 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 (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 52% of total spending.
$68.0M
126K claims
$539.90
$121.16
Clinic visit/encounter, all-inclusive
$68.0M
126K claims · 52.5%
Anesthesia services
$47.3M
90K claims · 36.5%
$8.1M
26K claims
$307.18
$21.91
Federally qualified health center visit, mental health
$8.1M
26K claims · 6.2%
$2.0M
80K claims
$25.01
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$2.0M
80K claims · 1.5%
$1.7M
6K claims
$302.92
$45.95
Chronic care management services, FQHC/RHC
$1.7M
6K claims · 1.3%
$462K
1K claims
$358.06
$47.08
Ophthalmological exam, comprehensive, established patient
$462K
1K claims · 0.4%
$458K
1K claims
$391.53
$59.72
Ophthalmological exam, comprehensive, new patient
$458K
1K claims · 0.4%
$441K
26K claims
$17.14
$25.06
Office/outpatient visit, low complexity
$441K
26K claims · 0.3%
$284K
12K claims
$23.82
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$284K
12K claims · 0.2%
Psychotherapy, 30 minutes
$219K
10K claims · 0.2%
Psychotherapy, 45 minutes
$143K
2K claims · 0.1%
$108K
2K claims · 0.1%
Hemoglobin A1c (glycated hemoglobin)
$50K
4K claims · 0.0%
Psychotherapy, 60 minutes
$44K
2K claims · 0.0%
$36K
908 claims
$39.60
$33.85
COVID-19 vaccine admin, Moderna, 2nd dose
$36K
908 claims · 0.0%
$34K
984 claims
$34.96
$25.93
COVID-19 vaccine admin, Moderna, 1st dose
$34K
984 claims · 0.0%
$25K
548 claims · 0.0%
$23K
1K claims · 0.0%
$23K
346 claims · 0.0%
$23K
5K claims · 0.0%
$21K
494 claims · 0.0%
$21K
1K claims
$15.18
$9.10
Developmental screening, per standardized instrument
$21K
1K claims · 0.0%
$18K
59 claims · 0.0%
$8K
58 claims · 0.0%
$6K
2K claims
$2.71
$12.59
Influenza virus detection, rapid test
$6K
2K claims · 0.0%
$6K
2K claims
$3.51
$57.85
Office/outpatient visit, new patient, low-mod complexity
$6K
2K claims · 0.0%
$5K
113 claims · 0.0%
$4K
255 claims
$16.75
$7.18
Influenza virus vaccine, quadrivalent, preservative-free, IM
$4K
255 claims · 0.0%
Tdap vaccine
$3K
1K claims · 0.0%
$3K
87 claims · 0.0%
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Clinic/Center, Mental Health (Including Community
$6.78B
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Community/Behavioral Health
$1.73B
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$1.40B
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$1.34B
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