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

Southern California Permanente Medical Group

Health Maintenance Organization·Riverside, CA·NPI: 1316979834SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $15.7M is at the below 25th percentile among 10 Health Maintenance Organization providers.

Total Paid

$15.7M

$15,655,234

Total Claims

1.7M

Beneficiaries

1.7M

1.0 claims/patient

Avg Cost/Claim

$9

🔍 Analysis

Provider Overview

Southern California Permanente Medical Group is a Health Maintenance Organization provider based in Riverside, CA. From the 2018–2024 period, this provider received $15.7M in Medicaid payments across 1.7M claims.

Why This Matters

At $15.7M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.

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