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

Mountain Park Health Center

Clinic/Center, Federally Qualified Health Center (FQHC)·Phoenix, AZ·NPI: 1669878567SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Billing above the 90th percentile for 5 procedure codes simultaneously.

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 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $352.1M is at the 90th percentile among 16 Clinic/Center, Federally Qualified Health Center (FQHC) providers.

Above 90th percentile for this specialty — higher spending than 14 of 16 peers

Active Billing Period:2018-012024-12(84 months)

Total Paid

$352.1M

$352,134,469

Total Claims

4.7M

Beneficiaries

3.7M

1.3 claims/patient

Avg Cost/Claim

$75

#194 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Mountain Park Health Center is a Clinic/Center, Federally Qualified Health Center (FQHC) provider based in Phoenix, AZ. From the 2018–2024 period, this provider received $352.1M in Medicaid payments across 4.7M claims.

Why This Matters

This provider received $352.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 44,016 Medicaid beneficiaries for a full year at average per-enrollee costs.

24% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$45.1M
+3%
2019
$46.5M
-1%
2020
$46.0M
+9%
2021
$50.0M
+4%
2022
$52.3M
+8%
2023
$56.6M
-2%
2024
$55.7M

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 98% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$345.4M

1.7M claims · 98.1%

Your Cost: $208.30/claim|Median: $121.16
1.7× median
59409Top 25%

Vaginal delivery only

$3.8M

4K claims · 1.1%

Your Cost: $873.02/claim|Median: $619.91
1.4× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$989K

16K claims · 0.3%

Your Cost: $60.38/claim|Median: $37.22
1.6× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$517K

8K claims · 0.1%

Your Cost: $66.49/claim|Median: $62.48
1.1× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$276K

4K claims · 0.1%

Your Cost: $72.33/claim|Median: $58.55
1.2× median
99231Top 25%

Subsequent hospital care, per day, low complexity

$207K

7K claims · 0.1%

Your Cost: $31.70/claim|Median: $16.77
1.9× median
76815Normal range

Ultrasound, pregnant uterus, limited

$136K

3K claims · 0.0%

Your Cost: $46.76/claim|Median: $36.79
1.3× median
76819Normal range

Fetal biophysical profile with non-stress test

$128K

2K claims · 0.0%

Your Cost: $60.03/claim|Median: $49.45
1.2× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$126K

1K claims · 0.0%

Your Cost: $98.98/claim|Median: $106.79
0.9× median
59025Normal range

Fetal non-stress test

$100K

10K claims · 0.0%

Your Cost: $9.53/claim|Median: $26.45
0.4× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$63K

1K claims · 0.0%

Your Cost: $61.25/claim|Median: $58.16
1.1× median
59514Top 10%

Cesarean delivery only

$59K

63 claims · 0.0%

Your Cost: $931.46/claim|Median: $452.80
2.1× median
76818Normal range

$52K

696 claims · 0.0%

Your Cost: $75.08/claim|Median: $68.15
1.1× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$51K

500K claims · 0.0%

Your Cost: $0.10/claim|Median: $37.81
0.0× median
76813Normal range

Ultrasound for fetal nuchal translucency measurement

$32K

501 claims · 0.0%

Your Cost: $64.06/claim|Median: $70.87
0.9× median
99221Top 10%

Initial hospital care, straightforward/low

$25K

294 claims · 0.0%

Your Cost: $84.93/claim|Median: $39.96
2.1× median
99462Normal range

$25K

861 claims · 0.0%

Your Cost: $28.93/claim|Median: $27.49
1.1× median
99463Normal range

$24K

322 claims · 0.0%

Your Cost: $75.38/claim|Median: $78.46
1.0× median
99232Top 5%

Subsequent hospital care, per day, moderate complexity

$18K

292 claims · 0.0%

Your Cost: $61.98/claim|Median: $23.99
2.6× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$16K

137K claims · 0.0%

Your Cost: $0.12/claim|Median: $53.41
0.0× median
99394Normal range

Preventive medicine, established patient, age 12-17

$12K

44K claims · 0.0%

Your Cost: $0.27/claim|Median: $80.15
0.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$11K

56K claims · 0.0%

Your Cost: $0.20/claim|Median: $69.35
0.0× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$11K

182K claims · 0.0%

Your Cost: $0.06/claim|Median: $17.85
0.0× median
99393Normal range

Preventive medicine, established patient, age 5-11

$11K

62K claims · 0.0%

Your Cost: $0.17/claim|Median: $74.82
0.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$10K

55K claims · 0.0%

Your Cost: $0.19/claim|Median: $75.18
0.0× median
99234Top 10%

$9K

81 claims · 0.0%

Your Cost: $113.63/claim|Median: $80.89
1.4× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$9K

135 claims · 0.0%

Your Cost: $63.05/claim|Median: $47.65
1.3× median
99233Top 10%

Subsequent hospital care, per day, high complexity

$8K

100 claims · 0.0%

Your Cost: $83.76/claim|Median: $35.30
2.4× median
76805Top 25%

Ultrasound, pregnant uterus, complete, single fetus

$8K

79 claims · 0.0%

Your Cost: $101.07/claim|Median: $74.78
1.4× median
90461Normal range

Immunization admin, additional vaccine, counseling

$7K

89K claims · 0.0%

Your Cost: $0.07/claim|Median: $6.93
0.0× median