County of San Diego
Community/Behavioral Health
San Diego, California
NPI: 1427101351
Risk Tier
High
Total Paid
$76.5M
$76,538,291
Total Claims
18K
Beneficiaries
17K
Avg Cost/Claim
$4,191.81
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $4,191.81 per claim for S9484 (Crisis intervention mental health services, per hour), which is 16.8× the national median of $249.51.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code S9484 (1 unique codes).
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