Is ALTAMED HEALTH SERVICES CORP flagged for Medicaid fraud?

ALTAMED HEALTH SERVICES CORP (NPI: 1255542601) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ALTAMED HEALTH SERVICES CORP bill Medicaid?

ALTAMED HEALTH SERVICES CORP 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 LOS ANGELES, CA.

What is NPI 1255542601?

NPI 1255542601 is the National Provider Identifier for ALTAMED HEALTH SERVICES CORP. They are a Clinic/Center, Federally Qualified Health Center (FQHC) provider based in LOS ANGELES, CA. This NPI is registered with the CMS NPI Registry.

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ALTAMED HEALTH SERVICES CORP

Clinic/Center, Federally Qualified Health Center (FQHC)·LOS ANGELES, CA·NPI: 1255542601Share

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 $50.8M 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

$50.8M

$50,838,749

Total Claims

750K

Beneficiaries

584K

1.3 claims/patient

Avg Cost/Claim

$68

Monthly Spending Trend

Yearly Spending

2018

$8.3M

-14%

2019

$7.2M

-8%

2020

$6.6M

+12%

2021

$7.4M

-20%

2022

$5.9M

+31%

2023

$7.7M

+1%

2024

$7.8M

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 76% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$38.4M

213K claims

$180.35

$121.16

1.5×

Top 25%

T1015Top 25%

Clinic visit/encounter, all-inclusive

$38.4M

213K claims · 75.5%

Your Cost: $180.35/claim|Median: $121.16

1.5× median

00003Anesthesia servicesSee all providers →

$11.4M

48K claims

$238.41

$223.77

1.1×

Normal range

00003Normal range

Anesthesia services

$11.4M

48K claims · 22.5%

Your Cost: $238.41/claim|Median: $223.77

1.1× median

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

$244K

119K claims

$2.05

$37.81

0.1×

Normal range

99213Normal range

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

$244K

119K claims · 0.5%

Your Cost: $2.05/claim|Median: $37.81

0.1× median

90834Psychotherapy, 45 minutesSee all providers →

$96K

5,038 claims

$19.07

$63.65

0.3×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$96K

5,038 claims · 0.2%

Your Cost: $19.07/claim|Median: $63.65

0.3× median

99392Preventive medicine, established patient, age 1-4See all providers →

$93K

8,824 claims

$10.49

$75.18

0.1×

Normal range

99392Normal range

Preventive medicine, established patient, age 1-4

$93K

8,824 claims · 0.2%

Your Cost: $10.49/claim|Median: $75.18

0.1× median

99394Preventive medicine, established patient, age 12-17See all providers →

$72K

4,000 claims

$18.00

$80.15

0.2×

Normal range

99394Normal range

Preventive medicine, established patient, age 12-17

$72K

4,000 claims · 0.1%

Your Cost: $18.00/claim|Median: $80.15

0.2× median

99393Preventive medicine, established patient, age 5-11See all providers →

$70K

5,078 claims

$13.84

$74.82

0.2×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$70K

5,078 claims · 0.1%

Your Cost: $13.84/claim|Median: $74.82

0.2× median

G9920 See all providers →

$58K

7,343 claims

$7.87

$6.56

1.2×

Normal range

G9920Normal range

$58K

7,343 claims · 0.1%

Your Cost: $7.87/claim|Median: $6.56

1.2× median

99391Preventive medicine, established patient, infant (under 1)See all providers →

$57K

7,186 claims

$7.95

$69.35

0.1×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$57K

7,186 claims · 0.1%

Your Cost: $7.95/claim|Median: $69.35

0.1× median

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

$48K

36K claims

$1.33

$53.41

0.0×

Normal range

99214Normal range

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

$48K

36K claims · 0.1%

Your Cost: $1.33/claim|Median: $53.41

0.0× median

96110Developmental screening, per standardized instrumentSee all providers →

$38K

1,837 claims

$20.82

$9.10

2.3×

Top 25%

96110Top 25%

Developmental screening, per standardized instrument

$38K

1,837 claims · 0.1%

Your Cost: $20.82/claim|Median: $9.10

2.3× median

99212Office/outpatient visit, low complexitySee all providers →

$27K

38K claims

$0.71

$25.06

0.0×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$27K

38K claims · 0.1%

Your Cost: $0.71/claim|Median: $25.06

0.0× median

G0467Federally qualified health center visit, mental healthSee all providers →

$24K

862 claims

$28.10

$21.91

1.3×

Normal range

G0467Normal range

Federally qualified health center visit, mental health

$24K

862 claims · 0.0%

Your Cost: $28.10/claim|Median: $21.91

1.3× median

90791Psychiatric diagnostic evaluationSee all providers →

$20K

771 claims

$26.47

$99.21

0.3×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$20K

771 claims · 0.0%

Your Cost: $26.47/claim|Median: $99.21

0.3× median

90686Influenza virus vaccine, quadrivalent, preservative-free, IMSee all providers →

$20K

12K claims

$1.71

$7.18

0.2×

Normal range

90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$20K

12K claims · 0.0%

Your Cost: $1.71/claim|Median: $7.18

0.2× median

90460Immunization administration, first vaccine/toxoid, with counselingSee all providers →

$12K

22K claims

$0.57

$17.85

0.0×

Normal range

90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$12K

22K claims · 0.0%

Your Cost: $0.57/claim|Median: $17.85

0.0× median

90832Psychotherapy, 30 minutesSee all providers →

$12K

955 claims

$12.51

$41.28

0.3×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$12K

955 claims · 0.0%

Your Cost: $12.51/claim|Median: $41.28

0.3× median

0064A See all providers →

$11K

209 claims

$52.98

$34.17

1.6×

Top 10%

0064ATop 10%

$11K

209 claims · 0.0%

Your Cost: $52.98/claim|Median: $34.17

1.6× median

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

$9K

197 claims

$46.85

$25.93

1.8×

Top 10%

0011ATop 10%

COVID-19 vaccine admin, Moderna, 1st dose

$9K

197 claims · 0.0%

Your Cost: $46.85/claim|Median: $25.93

1.8× median

90670 See all providers →

$8K

3,821 claims

$2.19

$5.94

0.4×

Normal range

90670Normal range

$8K

3,821 claims · 0.0%

Your Cost: $2.19/claim|Median: $5.94

0.4× median

83655 See all providers →

$8K

1,864 claims

$4.06

$10.49

0.4×

Normal range

83655Normal range

$8K

1,864 claims · 0.0%

Your Cost: $4.06/claim|Median: $10.49

0.4× median

90651HPV vaccine, 9-valentSee all providers →

$8K

1,800 claims

$4.19

$8.93

0.5×

Normal range

90651Normal range

HPV vaccine, 9-valent

$8K

1,800 claims · 0.0%

Your Cost: $4.19/claim|Median: $8.93

0.5× median

90680 See all providers →

$7K

2,579 claims

$2.59

$5.58

0.5×

Normal range

90680Normal range

$7K

2,579 claims · 0.0%

Your Cost: $2.59/claim|Median: $5.58

0.5× median

90698 See all providers →

$6K

2,116 claims

$3.06

$6.32

0.5×

Normal range

90698Normal range

$6K

2,116 claims · 0.0%

Your Cost: $3.06/claim|Median: $6.32

0.5× median

90633 See all providers →

$6K

1,719 claims

$3.62

$3.56

1.0×

Normal range

90633Normal range

$6K

1,719 claims · 0.0%

Your Cost: $3.62/claim|Median: $3.56

1.0× median

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

$6K

112 claims

$50.37

$33.85

1.5×

Top 10%

0012ATop 10%

COVID-19 vaccine admin, Moderna, 2nd dose

$6K

112 claims · 0.0%

Your Cost: $50.37/claim|Median: $33.85

1.5× median

92551Screening audiometry, pure tone, air onlySee all providers →

$6K

1,176 claims

$4.73

$6.61

0.7×

Normal range

92551Normal range

Screening audiometry, pure tone, air only

$6K

1,176 claims · 0.0%

Your Cost: $4.73/claim|Median: $6.61

0.7× median

D0120Periodic oral evaluation, established patientSee all providers →

$5K

2,880 claims

$1.74

$24.34

0.1×

Normal range

D0120Normal range

Periodic oral evaluation, established patient

$5K

2,880 claims · 0.0%

Your Cost: $1.74/claim|Median: $24.34

0.1× median

D1120Prophylaxis, adultSee all providers →

$5K

932 claims

$5.23

$33.86

0.2×

Normal range

D1120Normal range

Prophylaxis, adult

$5K

932 claims · 0.0%

Your Cost: $5.23/claim|Median: $33.86

0.2× median

90697 See all providers →

$5K

1,852 claims

$2.51

$7.24

0.3×

Normal range

90697Normal range

$5K

1,852 claims · 0.0%

Your Cost: $2.51/claim|Median: $7.24

0.3× median

D1208Topical application of fluoride, excluding varnishSee all providers →

$4K

1,951 claims

$2.30

$14.36

0.2×

Normal range

D1208Normal range

Topical application of fluoride, excluding varnish

$4K

1,951 claims · 0.0%

Your Cost: $2.30/claim|Median: $14.36

0.2× median

90461Immunization admin, additional vaccine, counselingSee all providers →

$4K

13K claims

$0.30

$6.93

0.0×

Normal range

90461Normal range

Immunization admin, additional vaccine, counseling

$4K

13K claims · 0.0%

Your Cost: $0.30/claim|Median: $6.93

0.0× median

J7307Etonogestrel implant system, including implant and suppliesSee all providers →

$4K

22 claims

$178.47

$786.43

0.2×

Normal range

J7307Normal range

Etonogestrel implant system, including implant and supplies

$4K

22 claims · 0.0%

Your Cost: $178.47/claim|Median: $786.43

0.2× median

90688 See all providers →

$4K

4,277 claims

$0.89

$9.00

0.1×

Normal range

90688Normal range

$4K

4,277 claims · 0.0%

Your Cost: $0.89/claim|Median: $9.00

0.1× median

90677 See all providers →

$3K

1,392 claims

$2.01

$12.96

0.2×

Normal range

90677Normal range

$3K

1,392 claims · 0.0%

Your Cost: $2.01/claim|Median: $12.96

0.2× median

90619 See all providers →

$3K

572 claims

$4.50

$8.36

0.5×

Normal range

90619Normal range

$3K

572 claims · 0.0%

Your Cost: $4.50/claim|Median: $8.36

0.5× median

85018 See all providers →

$2K

4,834 claims

$0.49

$1.71

0.3×

Normal range

85018Normal range

$2K

4,834 claims · 0.0%

Your Cost: $0.49/claim|Median: $1.71

0.3× median

90656 See all providers →

$2K

1,995 claims

$1.11

$8.67

0.1×

Normal range

90656Normal range

$2K

1,995 claims · 0.0%

Your Cost: $1.11/claim|Median: $8.67

0.1× median

90671 See all providers →

$2K

853 claims

$2.55

$8.59

0.3×

Normal range

90671Normal range

$2K

853 claims · 0.0%

Your Cost: $2.55/claim|Median: $8.59

0.3× median

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

$2K

402 claims

$5.04

$57.85

0.1×

Normal range

99203Normal range

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

$2K

402 claims · 0.0%

Your Cost: $5.04/claim|Median: $57.85

0.1× median

81025Urine pregnancy testSee all providers →

$2K

7,129 claims

$0.26

$4.81

0.1×

Normal range

81025Normal range

Urine pregnancy test

$2K

7,129 claims · 0.0%

Your Cost: $0.26/claim|Median: $4.81

0.1× median

90734 See all providers →

$2K

515 claims

$3.26

$6.40

0.5×

Normal range

90734Normal range

$2K

515 claims · 0.0%

Your Cost: $3.26/claim|Median: $6.40

0.5× median

90715Tdap vaccineSee all providers →

$1K

1,328 claims

$0.91

$10.32

0.1×

Normal range

90715Normal range

Tdap vaccine

$1K

1,328 claims · 0.0%

Your Cost: $0.91/claim|Median: $10.32

0.1× median

D0220Intraoral periapical radiographic image, first filmSee all providers →

$1K

4,168 claims

$0.29

$10.51

0.0×

Normal range

D0220Normal range

Intraoral periapical radiographic image, first film

$1K

4,168 claims · 0.0%

Your Cost: $0.29/claim|Median: $10.51

0.0× median

D1310Nutritional counseling for control of dental diseaseSee all providers →

$1K

986 claims

$1.17

$40.52

0.0×

Normal range

D1310Normal range

Nutritional counseling for control of dental disease

$1K

986 claims · 0.0%

Your Cost: $1.17/claim|Median: $40.52

0.0× median

90710MMRV vaccineSee all providers →

$1K

266 claims

$4.30

$7.00

0.6×

Normal range

90710Normal range

MMRV vaccine

$1K

266 claims · 0.0%

Your Cost: $4.30/claim|Median: $7.00

0.6× median

90480 See all providers →

$1K

892 claims

$1.23

$25.29

0.0×

Normal range

90480Normal range

$1K

892 claims · 0.0%

Your Cost: $1.23/claim|Median: $25.29

0.0× median

99395Preventive medicine, established patient, age 18-39See all providers →

$999

1,452 claims

$0.69

$72.71

0.0×

Normal range

99395Normal range

Preventive medicine, established patient, age 18-39

$999

1,452 claims · 0.0%

Your Cost: $0.69/claim|Median: $72.71

0.0× median

D0230Intraoral, periapical radiographic image, first filmSee all providers →

$997

4,871 claims

$0.20

$7.33

0.0×

Normal range

D0230Normal range

Intraoral, periapical radiographic image, first film

$997

4,871 claims · 0.0%

Your Cost: $0.20/claim|Median: $7.33

0.0× median

90696DTaP-IPV vaccineSee all providers →

$909

202 claims

$4.50

$5.95

0.8×

Normal range

90696Normal range

DTaP-IPV vaccine

$909

202 claims · 0.0%

Your Cost: $4.50/claim|Median: $5.95

0.8× median

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