County of Santa Clara
Clinic/Center Federally Qualified Health Center (FQHC)
San Jose, California
NPI: 1376538991
Risk Tier
Elevated
Total Paid
$127.9M
$127,878,847
Total Claims
1.2M
Beneficiaries
942K
Avg Cost/Claim
$106.32
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $410.60 per claim for T1015 (Clinic visit/encounter, all-inclusive), which is 3.4× the national median of $121.16.
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