Is WELLSPACE HEALTH flagged for Medicaid fraud?

WELLSPACE HEALTH (NPI: 1447332036) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does WELLSPACE HEALTH bill Medicaid?

WELLSPACE HEALTH 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 SACRAMENTO, CA.

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WELLSPACE HEALTH

Clinic/Center, Federally Qualified Health Center (FQHC)·SACRAMENTO, CA·NPI: 1447332036Share

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 $76.9M 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

$76.9M

$76,864,365

Total Claims

2.4M

Beneficiaries

2.1M

1.1 claims/patient

Avg Cost/Claim

$32

Monthly Spending Trend

Yearly Spending

2018

$2.3M

+52%

2019

$3.5M

+310%

2020

$14.3M

+32%

2021

$18.8M

-27%

2022

$13.7M

+19%

2023

$16.3M

-51%

2024

$8.0M

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 98% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$75.5M

501K claims

$150.82

$121.16

1.2×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$75.5M

501K claims · 98.3%

Your Cost: $150.82/claim|Median: $121.16

1.2× median

G0467Federally qualified health center visit, mental healthSee all providers →

$452K

13K claims

$36.01

$21.91

1.6×

Top 25%

G0467Top 25%

Federally qualified health center visit, mental health

$452K

13K claims · 0.6%

Your Cost: $36.01/claim|Median: $21.91

1.6× median

90832Psychotherapy, 30 minutesSee all providers →

$151K

14K claims

$10.71

$41.28

0.3×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$151K

14K claims · 0.2%

Your Cost: $10.71/claim|Median: $41.28

0.3× median

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

$149K

163K claims

$0.91

$37.81

0.0×

Normal range

99213Normal range

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

$149K

163K claims · 0.2%

Your Cost: $0.91/claim|Median: $37.81

0.0× median

99212Office/outpatient visit, low complexitySee all providers →

$102K

59K claims

$1.74

$25.06

0.1×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$102K

59K claims · 0.1%

Your Cost: $1.74/claim|Median: $25.06

0.1× median

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

$91K

53K claims

$1.70

$53.41

0.0×

Normal range

99214Normal range

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

$91K

53K claims · 0.1%

Your Cost: $1.70/claim|Median: $53.41

0.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$75K

3,293 claims

$22.81

$99.21

0.2×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$75K

3,293 claims · 0.1%

Your Cost: $22.81/claim|Median: $99.21

0.2× median

G0466 See all providers →

$61K

903 claims

$67.63

$63.31

1.1×

Normal range

G0466Normal range

$61K

903 claims · 0.1%

Your Cost: $67.63/claim|Median: $63.31

1.1× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$58K

2,438 claims

$23.83

$108.91

0.2×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$58K

2,438 claims · 0.1%

Your Cost: $23.83/claim|Median: $108.91

0.2× median

G0470Chronic care management services, FQHC/RHCSee all providers →

$54K

649 claims

$83.29

$45.95

1.8×

Top 25%

G0470Top 25%

Chronic care management services, FQHC/RHC

$54K

649 claims · 0.1%

Your Cost: $83.29/claim|Median: $45.95

1.8× median

D1120Prophylaxis, adultSee all providers →

$15K

3,697 claims

$4.06

$33.86

0.1×

Normal range

D1120Normal range

Prophylaxis, adult

$15K

3,697 claims · 0.0%

Your Cost: $4.06/claim|Median: $33.86

0.1× median

G0468 See all providers →

$14K

166 claims

$85.72

$43.74

2.0×

Top 25%

G0468Top 25%

$14K

166 claims · 0.0%

Your Cost: $85.72/claim|Median: $43.74

2.0× median

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

$14K

7,117 claims

$2.00

$57.85

0.0×

Normal range

99203Normal range

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

$14K

7,117 claims · 0.0%

Your Cost: $2.00/claim|Median: $57.85

0.0× median

G2025 See all providers →

$12K

709 claims

$16.69

$15.63

1.1×

Normal range

G2025Normal range

$12K

709 claims · 0.0%

Your Cost: $16.69/claim|Median: $15.63

1.1× median

97810 See all providers →

$11K

7,248 claims

$1.49

$23.92

0.1×

Normal range

97810Normal range

$11K

7,248 claims · 0.0%

Your Cost: $1.49/claim|Median: $23.92

0.1× median

D1310Nutritional counseling for control of dental diseaseSee all providers →

$11K

4,429 claims

$2.40

$40.52

0.1×

Normal range

D1310Normal range

Nutritional counseling for control of dental disease

$11K

4,429 claims · 0.0%

Your Cost: $2.40/claim|Median: $40.52

0.1× median

D1351Sealant, per toothSee all providers →

$8K

1,006 claims

$7.60

$26.10

0.3×

Normal range

D1351Normal range

Sealant, per tooth

$8K

1,006 claims · 0.0%

Your Cost: $7.60/claim|Median: $26.10

0.3× median

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

$6K

1,645 claims

$3.86

$84.03

0.0×

Normal range

99204Normal range

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

$6K

1,645 claims · 0.0%

Your Cost: $3.86/claim|Median: $84.03

0.0× median

59425Antepartum care only, 4-6 visitsSee all providers →

$6K

398 claims

$14.14

$63.63

0.2×

Normal range

59425Normal range

Antepartum care only, 4-6 visits

$6K

398 claims · 0.0%

Your Cost: $14.14/claim|Median: $63.63

0.2× median

D1208Topical application of fluoride, excluding varnishSee all providers →

$5K

3,764 claims

$1.42

$14.36

0.1×

Normal range

D1208Normal range

Topical application of fluoride, excluding varnish

$5K

3,764 claims · 0.0%

Your Cost: $1.42/claim|Median: $14.36

0.1× median

90834Psychotherapy, 45 minutesSee all providers →

$5K

246 claims

$21.49

$63.65

0.3×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$5K

246 claims · 0.0%

Your Cost: $21.49/claim|Median: $63.65

0.3× median

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

$5K

7,337 claims

$0.66

$69.35

0.0×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$5K

7,337 claims · 0.0%

Your Cost: $0.66/claim|Median: $69.35

0.0× median

0001ACOVID-19 vaccine admin, Pfizer, 1st doseSee all providers →

$4K

272 claims

$15.78

$33.72

0.5×

Normal range

0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$4K

272 claims · 0.0%

Your Cost: $15.78/claim|Median: $33.72

0.5× median

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

$4K

895 claims

$4.20

$25.93

0.2×

Normal range

0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$4K

895 claims · 0.0%

Your Cost: $4.20/claim|Median: $25.93

0.2× median

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

$3K

8,376 claims

$0.38

$75.18

0.0×

Normal range

99392Normal range

Preventive medicine, established patient, age 1-4

$3K

8,376 claims · 0.0%

Your Cost: $0.38/claim|Median: $75.18

0.0× median

99215Office/outpatient visit, high complexitySee all providers →

$3K

2,090 claims

$1.40

$74.09

0.0×

Normal range

99215Normal range

Office/outpatient visit, high complexity

$3K

2,090 claims · 0.0%

Your Cost: $1.40/claim|Median: $74.09

0.0× median

99211Office/outpatient visit, minimal complexitySee all providers →

$2K

3,969 claims

$0.59

$12.93

0.0×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$2K

3,969 claims · 0.0%

Your Cost: $0.59/claim|Median: $12.93

0.0× median

98940 See all providers →

$2K

6,867 claims

$0.29

$14.55

0.0×

Normal range

98940Normal range

$2K

6,867 claims · 0.0%

Your Cost: $0.29/claim|Median: $14.55

0.0× median

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

$2K

351 claims

$5.54

$33.85

0.2×

Normal range

0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$2K

351 claims · 0.0%

Your Cost: $5.54/claim|Median: $33.85

0.2× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$2K

4,294 claims

$0.42

$40.11

0.0×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$2K

4,294 claims · 0.0%

Your Cost: $0.42/claim|Median: $40.11

0.0× median

0002ACOVID-19 vaccine admin, Pfizer, 2nd doseSee all providers →

$2K

50 claims

$35.36

$36.70

1.0×

Normal range

0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$2K

50 claims · 0.0%

Your Cost: $35.36/claim|Median: $36.70

1.0× median

99381Preventive visit, new patient, infant (<1 yr)See all providers →

$1K

2,364 claims

$0.57

$73.46

0.0×

Normal range

99381Normal range

Preventive visit, new patient, infant (<1 yr)

$1K

2,364 claims · 0.0%

Your Cost: $0.57/claim|Median: $73.46

0.0× median

0071A See all providers →

$988

126 claims

$7.84

$38.71

0.2×

Normal range

0071ANormal range

$988

126 claims · 0.0%

Your Cost: $7.84/claim|Median: $38.71

0.2× median

96110Developmental screening, per standardized instrumentSee all providers →

$986

794 claims

$1.24

$9.10

0.1×

Normal range

96110Normal range

Developmental screening, per standardized instrument

$986

794 claims · 0.0%

Your Cost: $1.24/claim|Median: $9.10

0.1× median

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

$911

3,801 claims

$0.24

$80.15

0.0×

Normal range

99394Normal range

Preventive medicine, established patient, age 12-17

$911

3,801 claims · 0.0%

Your Cost: $0.24/claim|Median: $80.15

0.0× median

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

$690

5,827 claims

$0.12

$74.82

0.0×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$690

5,827 claims · 0.0%

Your Cost: $0.12/claim|Median: $74.82

0.0× median

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

$636

12K claims

$0.05

$6.61

0.0×

Normal range

92551Normal range

Screening audiometry, pure tone, air only

$636

12K claims · 0.0%

Your Cost: $0.05/claim|Median: $6.61

0.0× median

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

$581

10K claims

$0.06

$7.18

0.0×

Normal range

90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$581

10K claims · 0.0%

Your Cost: $0.06/claim|Median: $7.18

0.0× median

90633 See all providers →

$476

4,936 claims

$0.10

$3.56

0.0×

Normal range

90633Normal range

$476

4,936 claims · 0.0%

Your Cost: $0.10/claim|Median: $3.56

0.0× median

81025Urine pregnancy testSee all providers →

$435

5,036 claims

$0.09

$4.81

0.0×

Normal range

81025Normal range

Urine pregnancy test

$435

5,036 claims · 0.0%

Your Cost: $0.09/claim|Median: $4.81

0.0× median

H1003 See all providers →

$415

508 claims

$0.82

$10.04

0.1×

Normal range

H1003Normal range

$415

508 claims · 0.0%

Your Cost: $0.82/claim|Median: $10.04

0.1× median

90680 See all providers →

$379

3,733 claims

$0.10

$5.58

0.0×

Normal range

90680Normal range

$379

3,733 claims · 0.0%

Your Cost: $0.10/claim|Median: $5.58

0.0× median

83036Hemoglobin A1c (glycated hemoglobin)See all providers →

$375

3,758 claims

$0.10

$5.50

0.0×

Normal range

83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$375

3,758 claims · 0.0%

Your Cost: $0.10/claim|Median: $5.50

0.0× median

83655 See all providers →

$296

581 claims

$0.51

$10.49

0.0×

Normal range

83655Normal range

$296

581 claims · 0.0%

Your Cost: $0.51/claim|Median: $10.49

0.0× median

80305 See all providers →

$292

365 claims

$0.80

$7.44

0.1×

Normal range

80305Normal range

$292

365 claims · 0.0%

Your Cost: $0.80/claim|Median: $7.44

0.1× median

S9445 See all providers →

$281

657 claims

$0.43

$12.72

0.0×

Normal range

S9445Normal range

$281

657 claims · 0.0%

Your Cost: $0.43/claim|Median: $12.72

0.0× median

85018 See all providers →

$250

11K claims

$0.02

$1.71

0.0×

Normal range

85018Normal range

$250

11K claims · 0.0%

Your Cost: $0.02/claim|Median: $1.71

0.0× median

90674 See all providers →

$236

1,808 claims

$0.13

$15.16

0.0×

Normal range

90674Normal range

$236

1,808 claims · 0.0%

Your Cost: $0.13/claim|Median: $15.16

0.0× median

90651HPV vaccine, 9-valentSee all providers →

$225

3,022 claims

$0.07

$8.93

0.0×

Normal range

90651Normal range

HPV vaccine, 9-valent

$225

3,022 claims · 0.0%

Your Cost: $0.07/claim|Median: $8.93

0.0× median

99231Subsequent hospital care, per day, low complexitySee all providers →

$220

3,296 claims

$0.07

$16.77

0.0×

Normal range

99231Normal range

Subsequent hospital care, per day, low complexity

$220

3,296 claims · 0.0%

Your Cost: $0.07/claim|Median: $16.77

0.0× median

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$1.13B

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