Altamed Health Services Corp.
Clinic/Center Federally Qualified Health Center (FQHC)
Los Angeles, California
NPI: 1629283197
Risk Tier
Critical
Total Paid
$305.8M
$305,796,831
Total Claims
2.5M
Beneficiaries
1.9M
Avg Cost/Claim
$122.02
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (4)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $416.11 per claim for T1015 (Clinic visit/encounter, all-inclusive), which is 3.4× the national median of $121.16.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: T1015 at 3.4× median, 96110 at 5.5× median.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Spending Spike
Experienced a dramatic increase in billing over a short period.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024