Is WELLSPACE HEALTH flagged for Medicaid fraud?

WELLSPACE HEALTH (NPI: 1124257324) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does WELLSPACE HEALTH bill Medicaid?

WELLSPACE HEALTH received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinic/Center, Federally Qualified Health Center (FQHC) provider. Located in SACRAMENTO, CA.

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WELLSPACE HEALTH

Clinic/Center, Federally Qualified Health Center (FQHC)·SACRAMENTO, CA·NPI: 1124257324Share

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 $64.2M 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

$64.2M

$64,159,475

Total Claims

2.4M

Beneficiaries

1.7M

1.4 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018

$3.2M

+10%

2019

$3.5M

+191%

2020

$10.1M

+36%

2021

$13.7M

-18%

2022

$11.2M

+34%

2023

$15.1M

-50%

2024

$7.5M

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 93% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$59.5M

413K claims

$143.83

$121.16

1.2×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$59.5M

413K claims · 92.7%

Your Cost: $143.83/claim|Median: $121.16

1.2× median

00003Anesthesia servicesSee all providers →

$980K

4,661 claims

$210.20

$223.77

0.9×

Normal range

00003Normal range

Anesthesia services

$980K

4,661 claims · 1.5%

Your Cost: $210.20/claim|Median: $223.77

0.9× median

D1120Prophylaxis, adultSee all providers →

$649K

84K claims

$7.70

$33.86

0.2×

Normal range

D1120Normal range

Prophylaxis, adult

$649K

84K claims · 1.0%

Your Cost: $7.70/claim|Median: $33.86

0.2× median

D1208Topical application of fluoride, excluding varnishSee all providers →

$350K

85K claims

$4.11

$14.36

0.3×

Normal range

D1208Normal range

Topical application of fluoride, excluding varnish

$350K

85K claims · 0.5%

Your Cost: $4.11/claim|Median: $14.36

0.3× median

D0120Periodic oral evaluation, established patientSee all providers →

$316K

95K claims

$3.31

$24.34

0.1×

Normal range

D0120Normal range

Periodic oral evaluation, established patient

$316K

95K claims · 0.5%

Your Cost: $3.31/claim|Median: $24.34

0.1× median

D1351Sealant, per toothSee all providers →

$297K

65K claims

$4.60

$26.10

0.2×

Normal range

D1351Normal range

Sealant, per tooth

$297K

65K claims · 0.5%

Your Cost: $4.60/claim|Median: $26.10

0.2× median

G0467Federally qualified health center visit, mental healthSee all providers →

$270K

7,319 claims

$36.89

$21.91

1.7×

Top 25%

G0467Top 25%

Federally qualified health center visit, mental health

$270K

7,319 claims · 0.4%

Your Cost: $36.89/claim|Median: $21.91

1.7× median

D0230Intraoral, periapical radiographic image, first filmSee all providers →

$247K

390K claims

$0.63

$7.33

0.1×

Normal range

D0230Normal range

Intraoral, periapical radiographic image, first film

$247K

390K claims · 0.4%

Your Cost: $0.63/claim|Median: $7.33

0.1× median

D0274Bitewings, four radiographic imagesSee all providers →

$224K

64K claims

$3.49

$22.54

0.2×

Normal range

D0274Normal range

Bitewings, four radiographic images

$224K

64K claims · 0.3%

Your Cost: $3.49/claim|Median: $22.54

0.2× median

D0220Intraoral periapical radiographic image, first filmSee all providers →

$191K

98K claims

$1.94

$10.51

0.2×

Normal range

D0220Normal range

Intraoral periapical radiographic image, first film

$191K

98K claims · 0.3%

Your Cost: $1.94/claim|Median: $10.51

0.2× median

D2392Resin-based composite, two surfaces, posteriorSee all providers →

$173K

21K claims

$8.07

$71.00

0.1×

Normal range

D2392Normal range

Resin-based composite, two surfaces, posterior

$173K

21K claims · 0.3%

Your Cost: $8.07/claim|Median: $71.00

0.1× median

D2391Resin-based composite, one surface, posteriorSee all providers →

$136K

18K claims

$7.62

$54.60

0.1×

Normal range

D2391Normal range

Resin-based composite, one surface, posterior

$136K

18K claims · 0.2%

Your Cost: $7.62/claim|Median: $54.60

0.1× median

90832Psychotherapy, 30 minutesSee all providers →

$120K

8,234 claims

$14.52

$41.28

0.4×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$120K

8,234 claims · 0.2%

Your Cost: $14.52/claim|Median: $41.28

0.4× median

D1310Nutritional counseling for control of dental diseaseSee all providers →

$89K

105K claims

$0.85

$40.52

0.0×

Normal range

D1310Normal range

Nutritional counseling for control of dental disease

$89K

105K claims · 0.1%

Your Cost: $0.85/claim|Median: $40.52

0.0× median

D0170 See all providers →

$85K

7,377 claims

$11.52

$24.39

0.5×

Normal range

D0170Normal range

$85K

7,377 claims · 0.1%

Your Cost: $11.52/claim|Median: $24.39

0.5× median

G0071 See all providers →

$78K

5,207 claims

$14.96

$7.20

2.1×

Normal range

G0071Normal range

$78K

5,207 claims · 0.1%

Your Cost: $14.96/claim|Median: $7.20

2.1× median

D0210Intraoral, complete series of radiographic imagesSee all providers →

$68K

8,060 claims

$8.39

$46.33

0.2×

Normal range

D0210Normal range

Intraoral, complete series of radiographic images

$68K

8,060 claims · 0.1%

Your Cost: $8.39/claim|Median: $46.33

0.2× median

90791Psychiatric diagnostic evaluationSee all providers →

$63K

2,198 claims

$28.45

$99.21

0.3×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$63K

2,198 claims · 0.1%

Your Cost: $28.45/claim|Median: $99.21

0.3× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$47K

69K claims

$0.68

$37.81

0.0×

Normal range

99213Normal range

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

$47K

69K claims · 0.1%

Your Cost: $0.68/claim|Median: $37.81

0.0× median

D1352 See all providers →

$46K

9,626 claims

$4.74

$33.43

0.1×

Normal range

D1352Normal range

$46K

9,626 claims · 0.1%

Your Cost: $4.74/claim|Median: $33.43

0.1× median

G0466 See all providers →

$39K

513 claims

$75.56

$63.31

1.2×

Normal range

G0466Normal range

$39K

513 claims · 0.1%

Your Cost: $75.56/claim|Median: $63.31

1.2× median

D9999Unspecified adjunctive procedure, by reportSee all providers →

$37K

1,391 claims

$26.33

$37.60

0.7×

Normal range

D9999Normal range

Unspecified adjunctive procedure, by report

$37K

1,391 claims · 0.1%

Your Cost: $26.33/claim|Median: $37.60

0.7× median

D9430 See all providers →

$35K

7,813 claims

$4.50

$31.69

0.1×

Normal range

D9430Normal range

$35K

7,813 claims · 0.1%

Your Cost: $4.50/claim|Median: $31.69

0.1× median

D0150Comprehensive oral evaluation, new or established patientSee all providers →

$31K

9,002 claims

$3.46

$32.07

0.1×

Normal range

D0150Normal range

Comprehensive oral evaluation, new or established patient

$31K

9,002 claims · 0.0%

Your Cost: $3.46/claim|Median: $32.07

0.1× median

D0603 See all providers →

$24K

37K claims

$0.64

$6.54

0.1×

Normal range

D0603Normal range

$24K

37K claims · 0.0%

Your Cost: $0.64/claim|Median: $6.54

0.1× median

99212Office/outpatient visit, low complexitySee all providers →

$19K

39K claims

$0.49

$25.06

0.0×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$19K

39K claims · 0.0%

Your Cost: $0.49/claim|Median: $25.06

0.0× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$15K

19K claims

$0.79

$53.41

0.0×

Normal range

99214Normal range

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

$15K

19K claims · 0.0%

Your Cost: $0.79/claim|Median: $53.41

0.0× median

D7140Extraction, erupted tooth or exposed rootSee all providers →

$11K

753 claims

$13.98

$57.39

0.2×

Normal range

D7140Normal range

Extraction, erupted tooth or exposed root

$11K

753 claims · 0.0%

Your Cost: $13.98/claim|Median: $57.39

0.2× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$8K

2,442 claims

$3.25

$57.85

0.1×

Normal range

99203Normal range

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

$8K

2,442 claims · 0.0%

Your Cost: $3.25/claim|Median: $57.85

0.1× median

0012ACOVID-19 vaccine admin, Moderna, 2nd doseSee all providers →

$6K

424 claims

$14.01

$33.85

0.4×

Normal range

0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$6K

424 claims · 0.0%

Your Cost: $14.01/claim|Median: $33.85

0.4× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$6K

4,914 claims

$1.19

$40.11

0.0×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$6K

4,914 claims · 0.0%

Your Cost: $1.19/claim|Median: $40.11

0.0× median

D0272Bitewings, two radiographic imagesSee all providers →

$6K

3,799 claims

$1.45

$15.81

0.1×

Normal range

D0272Normal range

Bitewings, two radiographic images

$6K

3,799 claims · 0.0%

Your Cost: $1.45/claim|Median: $15.81

0.1× median

90834Psychotherapy, 45 minutesSee all providers →

$5K

212 claims

$21.53

$63.65

0.3×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$5K

212 claims · 0.0%

Your Cost: $21.53/claim|Median: $63.65

0.3× median

G2025 See all providers →

$5K

512 claims

$8.83

$15.63

0.6×

Normal range

G2025Normal range

$5K

512 claims · 0.0%

Your Cost: $8.83/claim|Median: $15.63

0.6× median

D0999Unspecified diagnostic procedure, by reportSee all providers →

$4K

72 claims

$60.00

$101.33

0.6×

Normal range

D0999Normal range

Unspecified diagnostic procedure, by report

$4K

72 claims · 0.0%

Your Cost: $60.00/claim|Median: $101.33

0.6× median

0011ACOVID-19 vaccine admin, Moderna, 1st doseSee all providers →

$4K

507 claims

$7.25

$25.93

0.3×

Normal range

0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$4K

507 claims · 0.0%

Your Cost: $7.25/claim|Median: $25.93

0.3× median

D9230Inhalation of nitrous oxide/analgesia, anxiolysisSee all providers →

$3K

270 claims

$12.59

$26.24

0.5×

Normal range

D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$3K

270 claims · 0.0%

Your Cost: $12.59/claim|Median: $26.24

0.5× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$3K

339 claims

$8.17

$108.91

0.1×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$3K

339 claims · 0.0%

Your Cost: $8.17/claim|Median: $108.91

0.1× median

D1999 See all providers →

$3K

45 claims

$60.00

$11.95

5.0×

Top 1%

D1999Top 1%

$3K

45 claims · 0.0%

Your Cost: $60.00/claim|Median: $11.95

5.0× median

D0270 See all providers →

$3K

1,788 claims

$1.46

$5.46

0.3×

Normal range

D0270Normal range

$3K

1,788 claims · 0.0%

Your Cost: $1.46/claim|Median: $5.46

0.3× median

D1320 See all providers →

$2K

5,752 claims

$0.28

$14.84

0.0×

Normal range

D1320Normal range

$2K

5,752 claims · 0.0%

Your Cost: $0.28/claim|Median: $14.84

0.0× median

D0145Oral evaluation for patient under 3 years, counselingSee all providers →

$2K

211 claims

$7.11

$57.30

0.1×

Normal range

D0145Normal range

Oral evaluation for patient under 3 years, counseling

$2K

211 claims · 0.0%

Your Cost: $7.11/claim|Median: $57.30

0.1× median

D4341Periodontal scaling, per quadrantSee all providers →

$1K

78 claims

$15.38

$70.00

0.2×

Normal range

D4341Normal range

Periodontal scaling, per quadrant

$1K

78 claims · 0.0%

Your Cost: $15.38/claim|Median: $70.00

0.2× median

D2393Resin-based composite, three surfaces, posteriorSee all providers →

$1K

284 claims

$3.81

$84.26

0.0×

Normal range

D2393Normal range

Resin-based composite, three surfaces, posterior

$1K

284 claims · 0.0%

Your Cost: $3.81/claim|Median: $84.26

0.0× median

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

$1K

582 claims

$1.78

$84.03

0.0×

Normal range

99204Normal range

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

$1K

582 claims · 0.0%

Your Cost: $1.78/claim|Median: $84.03

0.0× median

H1001 See all providers →

$907

584 claims

$1.55

$60.48

0.0×

Normal range

H1001Normal range

$907

584 claims · 0.0%

Your Cost: $1.55/claim|Median: $60.48

0.0× median

S9445 See all providers →

$832

1,040 claims

$0.80

$12.72

0.1×

Normal range

S9445Normal range

$832

1,040 claims · 0.0%

Your Cost: $0.80/claim|Median: $12.72

0.1× median

0031ACOVID-19 vaccine admin, J&J, single doseSee all providers →

$804

86 claims

$9.35

$32.49

0.3×

Normal range

0031ANormal range

COVID-19 vaccine admin, J&J, single dose

$804

86 claims · 0.0%

Your Cost: $9.35/claim|Median: $32.49

0.3× median

0064A See all providers →

$761

55 claims

$13.84

$34.17

0.4×

Normal range

0064ANormal range

$761

55 claims · 0.0%

Your Cost: $13.84/claim|Median: $34.17

0.4× median

0002ACOVID-19 vaccine admin, Pfizer, 2nd doseSee all providers →

$737

58 claims

$12.71

$36.70

0.3×

Normal range

0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$737

58 claims · 0.0%

Your Cost: $12.71/claim|Median: $36.70

0.3× median

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