Family Healthcare Network
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 5 procedure codes: T1015 at 2.5× median, 98940 at 20.3× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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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
Bills $295.68 per claim for 98940 — 20.3× the national median of $14.55.
Billing in the top 1% nationally for 1 procedure code: 98940.
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 24 providers in this specialty
This provider's total spending of $218.3M is at the 75th percentile among 24 Clinic/Center Federally Qualified Health Center (FQHC) providers.
Total Paid
$218.3M
$218,299,626
Total Claims
2.3M
Beneficiaries
1.6M
1.4 claims/patient
Avg Cost/Claim
$96
#393 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Family Healthcare Network is a Clinic/Center Federally Qualified Health Center (FQHC) provider based in Fresno, CA. From the 2018–2024 period, this provider received $218.3M in Medicaid payments across 2.3M claims.
Why This Matters
This provider received $218.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,287 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
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 90% of total spending.
$196.5M
653K claims
$300.71
$121.16
Clinic visit/encounter, all-inclusive
$196.5M
653K claims · 90.0%
Anesthesia services
$19.5M
54K claims · 8.9%
$933K
26K claims
$36.19
$21.91
Federally qualified health center visit, mental health
$933K
26K claims · 0.4%
$345K
475K claims
$0.73
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$345K
475K claims · 0.2%
$314K
1K claims · 0.1%
$281K
87K claims
$3.22
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$281K
87K claims · 0.1%
$133K
6K claims
$23.78
$47.08
Ophthalmological exam, comprehensive, established patient
$133K
6K claims · 0.1%
$83K
2K claims · 0.0%
$54K
25K claims
$2.20
$57.85
Office/outpatient visit, new patient, low-mod complexity
$54K
25K claims · 0.0%
$47K
147K claims
$0.32
$25.06
Office/outpatient visit, low complexity
$47K
147K claims · 0.0%
$37K
2K claims
$16.46
$84.03
Office/outpatient visit, new patient, mod-high complexity
$37K
2K claims · 0.0%
$30K
194K claims · 0.0%
Psychiatric diagnostic evaluation
$19K
540 claims · 0.0%
$16K
622 claims
$25.72
$137.85
Other specified case management service, per 15 minutes
$16K
622 claims · 0.0%
$9K
13K claims
$0.67
$40.11
Office/outpatient visit, new patient, low complexity
$9K
13K claims · 0.0%
$8K
7K claims
$1.21
$9.56
Therapeutic injection, subcutaneous/intramuscular
$8K
7K claims · 0.0%
$8K
6K claims · 0.0%
Psychotherapy, 30 minutes
$5K
379 claims · 0.0%
$4K
30K claims
$0.14
$7.18
Influenza virus vaccine, quadrivalent, preservative-free, IM
$4K
30K claims · 0.0%
$3K
3K claims · 0.0%
$2K
7K claims
$0.32
$72.71
Preventive medicine, established patient, age 18-39
$2K
7K claims · 0.0%
$2K
236 claims
$8.42
$62.48
Initial hospital or birthing center care, newborn, per day
$2K
236 claims · 0.0%
Unclassified drugs
$2K
1K claims · 0.0%
$2K
5K claims
$0.35
$73.46
Preventive visit, new patient, infant (<1 yr)
$2K
5K claims · 0.0%
$2K
382 claims · 0.0%
$2K
19K claims
$0.08
$69.35
Preventive medicine, established patient, infant (under 1)
$2K
19K claims · 0.0%
Psychotherapy, 45 minutes
$2K
87 claims · 0.0%
$1K
3K claims
$0.45
$76.06
Preventive medicine, established patient, age 40-64
$1K
3K claims · 0.0%
COVID-19 vaccine admin, Moderna, 1st dose
$1K
18 claims · 0.0%
$1K
18 claims · 0.0%
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Clinic/Center, Mental Health (Including Community
$6.78B
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$1.73B
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$1.40B
City & County of San Francisco
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$1.13B
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