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

County of San Diego

Public Health or Welfare

San Diego, California

NPI: 1225255375

Risk Tier

Elevated

Total Paid

$642.5M

$642,451,488

Total Claims

5.5M

Beneficiaries

1.1M

Avg Cost/Claim

$117.77

Active billing period: 82 months (2018-01 to 2024-10)

Statistical Fraud Flags (1)

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 33 procedure codes: H0004 at 2.0× median, H0005 at 1.8× median.

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