Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Kaiser Foundation Health Plan INC

Health Maintenance Organization

Oakland, California

NPI: 1215504824

Risk Tier

Elevated

Total Paid

$12.8M

$12,770,956

Total Claims

314K

Beneficiaries

253K

Avg Cost/Claim

$40.69

Statistical Fraud Flags (1)

Explosive Growth

Billing increased over 500% year-over-year — far beyond normal growth patterns.

Billing grew 12913% from 2022 to 2023.

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