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

North County Health Project, Inc.

Clinic/Center, Federally Qualified Health Center (FQHC)·San Marcos, CA·NPI: 1245246917Share

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 $125.7M is at the 25th percentile among 16 Clinic/Center, Federally Qualified Health Center (FQHC) providers.

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

Total Paid

$125.7M

$125,681,023

Total Claims

3.7M

Beneficiaries

2.9M

1.3 claims/patient

Avg Cost/Claim

$34

#936 of 618K providers by total spending(top 0.2%)

🔍 Analysis

Provider Overview

North County Health Project, Inc. is a Clinic/Center, Federally Qualified Health Center (FQHC) provider based in San Marcos, CA. From the 2018–2024 period, this provider received $125.7M in Medicaid payments across 3.7M claims.

Important Context

  • ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.

Why This Matters

This provider received $125.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,710 Medicaid beneficiaries for a full year at average per-enrollee costs.

13% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$18.8M
-16%
2019
$15.9M
-6%
2020
$14.9M
+2%
2021
$15.1M
+11%
2022
$16.8M
+36%
2023
$22.9M
-8%
2024
$21.2M

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 82% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$103.4M

547K claims · 82.3%

Your Cost: $188.92/claim|Median: $121.16
1.6× median
00003Normal range

Anesthesia services

$18.2M

76K claims · 14.5%

Your Cost: $241.13/claim|Median: $223.77
1.1× median
99213Normal range

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

$705K

460K claims · 0.6%

Your Cost: $1.53/claim|Median: $37.81
0.0× median
G9920Normal range

$533K

44K claims · 0.4%

Your Cost: $12.17/claim|Median: $6.56
1.9× median
90832Normal range

Psychotherapy, 30 minutes

$452K

95K claims · 0.4%

Your Cost: $4.76/claim|Median: $41.28
0.1× median
G9008Top 5%

Coordination of long-term care services, per month

$449K

1K claims · 0.4%

Your Cost: $402.40/claim|Median: $66.78
6.0× median
G9012Top 5%

Other specified case management service, per 15 minutes

$288K

695 claims · 0.2%

Your Cost: $415.04/claim|Median: $137.85
3.0× median
98941Normal range

Chiropractic manipulative treatment, 3-4 spinal regions

$280K

61K claims · 0.2%

Your Cost: $4.61/claim|Median: $20.83
0.2× median
59425Normal range

Antepartum care only, 4-6 visits

$204K

4K claims · 0.2%

Your Cost: $53.76/claim|Median: $63.63
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$155K

176K claims · 0.1%

Your Cost: $0.88/claim|Median: $25.06
0.0× median
90791Normal range

Psychiatric diagnostic evaluation

$104K

8K claims · 0.1%

Your Cost: $13.82/claim|Median: $99.21
0.1× median
G0467Normal range

Federally qualified health center visit, mental health

$86K

13K claims · 0.1%

Your Cost: $6.83/claim|Median: $21.91
0.3× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$82K

2K claims · 0.1%

Your Cost: $52.44/claim|Median: $74.78
0.7× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$66K

6K claims · 0.1%

Your Cost: $11.75/claim|Median: $108.91
0.1× median
90834Normal range

Psychotherapy, 45 minutes

$64K

7K claims · 0.1%

Your Cost: $9.00/claim|Median: $63.65
0.1× median
99404Normal range

$45K

3K claims · 0.0%

Your Cost: $15.00/claim|Median: $104.92
0.1× median
0002ATop 5%

COVID-19 vaccine admin, Pfizer, 2nd dose

$44K

652 claims · 0.0%

Your Cost: $66.79/claim|Median: $36.70
1.8× median
0001ATop 5%

COVID-19 vaccine admin, Pfizer, 1st dose

$42K

629 claims · 0.0%

Your Cost: $66.89/claim|Median: $33.72
2.0× median
99214Normal range

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

$35K

71K claims · 0.0%

Your Cost: $0.50/claim|Median: $53.41
0.0× median
G0511Normal range

RHC/FQHC visit, psychiatric collaborative care model

$26K

8K claims · 0.0%

Your Cost: $3.23/claim|Median: $11.35
0.3× median
96110Normal range

Developmental screening, per standardized instrument

$24K

54K claims · 0.0%

Your Cost: $0.45/claim|Median: $9.10
0.1× median
0011ATop 5%

COVID-19 vaccine admin, Moderna, 1st dose

$21K

377 claims · 0.0%

Your Cost: $56.56/claim|Median: $25.93
2.2× median
0012ATop 10%

COVID-19 vaccine admin, Moderna, 2nd dose

$21K

347 claims · 0.0%

Your Cost: $59.66/claim|Median: $33.85
1.8× median
G9919Normal range

$19K

2K claims · 0.0%

Your Cost: $10.67/claim|Median: $8.66
1.2× median
99401Normal range

$17K

45K claims · 0.0%

Your Cost: $0.38/claim|Median: $16.53
0.0× median
G2025Normal range

$17K

2K claims · 0.0%

Your Cost: $7.68/claim|Median: $15.63
0.5× median
0064ATop 5%

$15K

225 claims · 0.0%

Your Cost: $66.40/claim|Median: $34.17
1.9× median
0054ATop 10%

$14K

212 claims · 0.0%

Your Cost: $65.74/claim|Median: $35.83
1.8× median
0072ATop 10%

$11K

167 claims · 0.0%

Your Cost: $67.00/claim|Median: $39.57
1.7× median
H1001Normal range

$9K

11K claims · 0.0%

Your Cost: $0.84/claim|Median: $60.48
0.0× median