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

⚖️ Compare🖨️ Print Report

ELICA HEALTH CENTERS

Clinic/Center, Federally Qualified Health Center (FQHC)·SACRAMENTO, CA·NPI: 1093974065Share

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 $94.2M is at the below 25th percentile among 16 Clinic/Center, Federally Qualified Health Center (FQHC) providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$94.2M

$94,193,941

Total Claims

2.2M

Beneficiaries

1.8M

1.3 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$14.4M
+5%
2019
$15.1M
+13%
2020
$17.2M
+15%
2021
$19.7M
-37%
2022
$12.3M
-29%
2023
$8.7M
-23%
2024
$6.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 94% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$88.5M

418K claims · 93.9%

Your Cost: $211.85/claim|Median: $121.16
1.7× median
00003Normal range

Anesthesia services

$1.3M

5,525 claims · 1.4%

Your Cost: $240.35/claim|Median: $223.77
1.1× median
G9012Normal range

Other specified case management service, per 15 minutes

$939K

12K claims · 1.0%

Your Cost: $79.81/claim|Median: $137.85
0.6× median
G0467Normal range

Federally qualified health center visit, mental health

$470K

25K claims · 0.5%

Your Cost: $18.98/claim|Median: $21.91
0.9× median
99213Normal range

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

$253K

407K claims · 0.3%

Your Cost: $0.62/claim|Median: $37.81
0.0× median
90791Normal range

Psychiatric diagnostic evaluation

$240K

6,909 claims · 0.3%

Your Cost: $34.67/claim|Median: $99.21
0.3× median
D1120Normal range

Prophylaxis, adult

$224K

11K claims · 0.2%

Your Cost: $19.92/claim|Median: $33.86
0.6× median
D1206Normal range

Topical application of fluoride varnish

$213K

20K claims · 0.2%

Your Cost: $10.55/claim|Median: $18.12
0.6× median
90832Normal range

Psychotherapy, 30 minutes

$188K

13K claims · 0.2%

Your Cost: $14.10/claim|Median: $41.28
0.3× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$140K

12K claims · 0.1%

Your Cost: $11.60/claim|Median: $32.07
0.4× median
D0120Normal range

Periodic oral evaluation, established patient

$123K

9,898 claims · 0.1%

Your Cost: $12.43/claim|Median: $24.34
0.5× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$110K

4,614 claims · 0.1%

Your Cost: $23.91/claim|Median: $71.00
0.3× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$102K

3,919 claims · 0.1%

Your Cost: $26.00/claim|Median: $33.85
0.8× median
99214Normal range

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

$97K

53K claims · 0.1%

Your Cost: $1.82/claim|Median: $53.41
0.0× median
G9008Top 5%

Coordination of long-term care services, per month

$88K

219 claims · 0.1%

Your Cost: $404.06/claim|Median: $66.78
6.1× median
D4341Normal range

Periodontal scaling, per quadrant

$85K

4,474 claims · 0.1%

Your Cost: $19.07/claim|Median: $70.00
0.3× median
D2391Normal range

Resin-based composite, one surface, posterior

$79K

4,404 claims · 0.1%

Your Cost: $17.97/claim|Median: $54.60
0.3× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$78K

3,919 claims · 0.1%

Your Cost: $19.84/claim|Median: $25.93
0.8× median
D9999Normal range

Unspecified adjunctive procedure, by report

$68K

869 claims · 0.1%

Your Cost: $78.59/claim|Median: $37.60
2.1× median
D9430Normal range

$66K

9,158 claims · 0.1%

Your Cost: $7.19/claim|Median: $31.69
0.2× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$64K

26K claims · 0.1%

Your Cost: $2.48/claim|Median: $57.85
0.0× median
D0210Normal range

Intraoral, complete series of radiographic images

$64K

7,000 claims · 0.1%

Your Cost: $9.14/claim|Median: $46.33
0.2× median
D0220Normal range

Intraoral periapical radiographic image, first film

$64K

17K claims · 0.1%

Your Cost: $3.68/claim|Median: $10.51
0.4× median
99212Normal range

Office/outpatient visit, low complexity

$57K

141K claims · 0.1%

Your Cost: $0.40/claim|Median: $25.06
0.0× median
D1351Normal range

Sealant, per tooth

$55K

3,178 claims · 0.1%

Your Cost: $17.32/claim|Median: $26.10
0.7× median
D1110Normal range

Prophylaxis, adult cleaning

$53K

5,219 claims · 0.1%

Your Cost: $10.25/claim|Median: $43.38
0.2× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$47K

17K claims · 0.0%

Your Cost: $2.78/claim|Median: $7.33
0.4× median
90834Normal range

Psychotherapy, 45 minutes

$43K

2,318 claims · 0.0%

Your Cost: $18.48/claim|Median: $63.65
0.3× median
D7140Normal range

Extraction, erupted tooth or exposed root

$40K

2,296 claims · 0.0%

Your Cost: $17.39/claim|Median: $57.39
0.3× median
D0274Normal range

Bitewings, four radiographic images

$36K

7,821 claims · 0.0%

Your Cost: $4.66/claim|Median: $22.54
0.2× median
D1310Normal range

Nutritional counseling for control of dental disease

$33K

13K claims · 0.0%

Your Cost: $2.45/claim|Median: $40.52
0.1× median
D2740Normal range

Crown, porcelain/ceramic substrate

$32K

106 claims · 0.0%

Your Cost: $300.15/claim|Median: $509.58
0.6× median
D4910Normal range

$25K

477 claims · 0.0%

Your Cost: $52.85/claim|Median: $75.56
0.7× median
G2025Normal range

$16K

6,336 claims · 0.0%

Your Cost: $2.57/claim|Median: $15.63
0.2× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$16K

696 claims · 0.0%

Your Cost: $22.35/claim|Median: $108.91
0.2× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$15K

2,364 claims · 0.0%

Your Cost: $6.43/claim|Median: $84.03
0.1× median
0064ANormal range

$11K

758 claims · 0.0%

Your Cost: $15.16/claim|Median: $34.17
0.4× median
D0603Normal range

$11K

10K claims · 0.0%

Your Cost: $1.05/claim|Median: $6.54
0.2× median
G0511Normal range

RHC/FQHC visit, psychiatric collaborative care model

$10K

4,506 claims · 0.0%

Your Cost: $2.19/claim|Median: $11.35
0.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$9K

9,147 claims · 0.0%

Your Cost: $1.02/claim|Median: $75.18
0.0× median
G0108Normal range

Diabetes self-management training, individual

$9K

1,369 claims · 0.0%

Your Cost: $6.54/claim|Median: $35.89
0.2× median
D0240Normal range

$9K

1,184 claims · 0.0%

Your Cost: $7.37/claim|Median: $15.24
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$8K

5,454 claims · 0.0%

Your Cost: $1.56/claim|Median: $40.11
0.0× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$8K

1,006 claims · 0.0%

Your Cost: $8.44/claim|Median: $57.30
0.1× median
G0466Normal range

$8K

334 claims · 0.0%

Your Cost: $24.05/claim|Median: $63.31
0.4× median
99393Normal range

Preventive medicine, established patient, age 5-11

$7K

8,002 claims · 0.0%

Your Cost: $0.91/claim|Median: $74.82
0.0× median
D0330Normal range

Panoramic radiographic image

$7K

1,902 claims · 0.0%

Your Cost: $3.74/claim|Median: $37.36
0.1× median
98940Normal range

$7K

7,792 claims · 0.0%

Your Cost: $0.88/claim|Median: $14.55
0.1× median
99383Normal range

Preventive visit, new patient, late childhood (5-11 yr)

$6K

3,387 claims · 0.0%

Your Cost: $1.63/claim|Median: $81.92
0.0× median
D0140Normal range

Limited oral evaluation, problem focused

$5K

2,653 claims · 0.0%

Your Cost: $2.06/claim|Median: $27.07
0.1× median

Other Top Providers in California

View all →

Los Angeles County Department of Mental Health

Clinic/Center, Mental Health (Including Community

$6.78B

County of Santa Clara

Community/Behavioral Health

$1.73B

County of Riverside

Community/Behavioral Health

$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

Similar Providers

Other top providers in Clinic/Center, Federally Qualified Health Center (FQHC)

El Rio Santa Cruz Neighborhood Health Center, INC

Tucson, AZ

$360.3M

Mountain Park Health Center

Phoenix, AZ

$352.1M

La Maestra Family Clinic, Inc.

San Diego, CA

$202.1M

Neighborhood Healthcare

Hemet, CA

$160.4M

Centro DE Salud DE La Comunidad DE San Ysidro, Inc.

San Ysidro, CA

$157.3M

← All providersAll providers in California →How we detect fraud →