Is VENICE FAMILY CLINIC flagged for Medicaid fraud?

VENICE FAMILY CLINIC (NPI: 1669418513) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does VENICE FAMILY CLINIC bill Medicaid?

VENICE FAMILY CLINIC 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 VENICE, CA.

What is NPI 1669418513?

NPI 1669418513 is the National Provider Identifier for VENICE FAMILY CLINIC. They are a Clinic/Center, Federally Qualified Health Center (FQHC) provider based in VENICE, CA. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

VENICE FAMILY CLINIC

Clinic/Center, Federally Qualified Health Center (FQHC)·VENICE, CA·NPI: 1669418513Share

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 $54.8M 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

$54.8M

$54,765,223

Total Claims

1.2M

Beneficiaries

969K

1.3 claims/patient

Avg Cost/Claim

$44

Monthly Spending Trend

Yearly Spending

2018

$4.0M

-18%

2019

$3.3M

+45%

2020

$4.8M

+34%

2021

$6.4M

+56%

2022

$10.0M

+17%

2023

$11.7M

+24%

2024

$14.5M

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 94% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$51.6M

231K claims

$222.90

$121.16

1.8×

Top 25%

T1015Top 25%

Clinic visit/encounter, all-inclusive

$51.6M

231K claims · 94.2%

Your Cost: $222.90/claim|Median: $121.16

1.8× median

00003Anesthesia servicesSee all providers →

$586K

1,704 claims

$344.02

$223.77

1.5×

Top 25%

00003Top 25%

Anesthesia services

$586K

1,704 claims · 1.1%

Your Cost: $344.02/claim|Median: $223.77

1.5× median

90832Psychotherapy, 30 minutesSee all providers →

$428K

20K claims

$21.24

$41.28

0.5×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$428K

20K claims · 0.8%

Your Cost: $21.24/claim|Median: $41.28

0.5× median

90834Psychotherapy, 45 minutesSee all providers →

$399K

15K claims

$26.77

$63.65

0.4×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$399K

15K claims · 0.7%

Your Cost: $26.77/claim|Median: $63.65

0.4× median

G9012Other specified case management service, per 15 minutesSee all providers →

$234K

13K claims

$18.36

$137.85

0.1×

Normal range

G9012Normal range

Other specified case management service, per 15 minutes

$234K

13K claims · 0.4%

Your Cost: $18.36/claim|Median: $137.85

0.1× median

90837Psychotherapy, 60 minutesSee all providers →

$229K

4,708 claims

$48.69

$85.66

0.6×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$229K

4,708 claims · 0.4%

Your Cost: $48.69/claim|Median: $85.66

0.6× median

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

$214K

175K claims

$1.23

$53.41

0.0×

Normal range

99214Normal range

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

$214K

175K claims · 0.4%

Your Cost: $1.23/claim|Median: $53.41

0.0× median

G9008Coordination of long-term care services, per monthSee all providers →

$185K

12K claims

$15.95

$66.78

0.2×

Normal range

G9008Normal range

Coordination of long-term care services, per month

$185K

12K claims · 0.3%

Your Cost: $15.95/claim|Median: $66.78

0.2× median

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

$141K

248K claims

$0.57

$37.81

0.0×

Normal range

99213Normal range

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

$141K

248K claims · 0.3%

Your Cost: $0.57/claim|Median: $37.81

0.0× median

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

$75K

9,556 claims

$7.86

$75.18

0.1×

Normal range

99392Normal range

Preventive medicine, established patient, age 1-4

$75K

9,556 claims · 0.1%

Your Cost: $7.86/claim|Median: $75.18

0.1× median

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

$69K

5,633 claims

$12.21

$80.15

0.2×

Normal range

99394Normal range

Preventive medicine, established patient, age 12-17

$69K

5,633 claims · 0.1%

Your Cost: $12.21/claim|Median: $80.15

0.2× median

96110Developmental screening, per standardized instrumentSee all providers →

$68K

4,137 claims

$16.52

$9.10

1.8×

Top 25%

96110Top 25%

Developmental screening, per standardized instrument

$68K

4,137 claims · 0.1%

Your Cost: $16.52/claim|Median: $9.10

1.8× median

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

$68K

7,307 claims

$9.34

$74.82

0.1×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$68K

7,307 claims · 0.1%

Your Cost: $9.34/claim|Median: $74.82

0.1× median

G0467Federally qualified health center visit, mental healthSee all providers →

$52K

3,711 claims

$14.14

$21.91

0.6×

Normal range

G0467Normal range

Federally qualified health center visit, mental health

$52K

3,711 claims · 0.1%

Your Cost: $14.14/claim|Median: $21.91

0.6× median

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

$49K

732 claims

$66.62

$25.93

2.6×

Top 5%

0011ATop 5%

COVID-19 vaccine admin, Moderna, 1st dose

$49K

732 claims · 0.1%

Your Cost: $66.62/claim|Median: $25.93

2.6× median

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

$45K

678 claims

$67.00

$33.85

2.0×

Top 5%

0012ATop 5%

COVID-19 vaccine admin, Moderna, 2nd dose

$45K

678 claims · 0.1%

Your Cost: $67.00/claim|Median: $33.85

2.0× median

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

$35K

22K claims

$1.58

$6.61

0.2×

Normal range

92551Normal range

Screening audiometry, pure tone, air only

$35K

22K claims · 0.1%

Your Cost: $1.58/claim|Median: $6.61

0.2× median

G9920 See all providers →

$35K

7,622 claims

$4.56

$6.56

0.7×

Normal range

G9920Normal range

$35K

7,622 claims · 0.1%

Your Cost: $4.56/claim|Median: $6.56

0.7× median

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

$33K

2,813 claims

$11.67

$69.35

0.2×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$33K

2,813 claims · 0.1%

Your Cost: $11.67/claim|Median: $69.35

0.2× median

0064A See all providers →

$20K

295 claims

$67.00

$34.17

2.0×

Top 5%

0064ATop 5%

$20K

295 claims · 0.0%

Your Cost: $67.00/claim|Median: $34.17

2.0× median

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

$20K

21K claims

$0.94

$7.18

0.1×

Normal range

90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$20K

21K claims · 0.0%

Your Cost: $0.94/claim|Median: $7.18

0.1× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$19K

627 claims

$30.52

$108.91

0.3×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$19K

627 claims · 0.0%

Your Cost: $30.52/claim|Median: $108.91

0.3× median

92014Ophthalmological exam, comprehensive, established patientSee all providers →

$13K

2,703 claims

$4.64

$47.08

0.1×

Normal range

92014Normal range

Ophthalmological exam, comprehensive, established patient

$13K

2,703 claims · 0.0%

Your Cost: $4.64/claim|Median: $47.08

0.1× median

85018 See all providers →

$10K

36K claims

$0.29

$1.71

0.2×

Normal range

85018Normal range

$10K

36K claims · 0.0%

Your Cost: $0.29/claim|Median: $1.71

0.2× median

90756Influenza virus vaccine, quadrivalentSee all providers →

$10K

855 claims

$11.83

$14.34

0.8×

Normal range

90756Normal range

Influenza virus vaccine, quadrivalent

$10K

855 claims · 0.0%

Your Cost: $11.83/claim|Median: $14.34

0.8× median

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

$8K

125 claims

$67.00

$33.72

2.0×

Top 5%

0001ATop 5%

COVID-19 vaccine admin, Pfizer, 1st dose

$8K

125 claims · 0.0%

Your Cost: $67.00/claim|Median: $33.72

2.0× median

90471Immunization administration, 1 vaccine, percutaneous/ID/SC/IMSee all providers →

$8K

36K claims

$0.23

$9.80

0.0×

Normal range

90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$8K

36K claims · 0.0%

Your Cost: $0.23/claim|Median: $9.80

0.0× median

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

$8K

119 claims

$67.00

$36.70

1.8×

Top 5%

0002ATop 5%

COVID-19 vaccine admin, Pfizer, 2nd dose

$8K

119 claims · 0.0%

Your Cost: $67.00/claim|Median: $36.70

1.8× median

0031ACOVID-19 vaccine admin, J&J, single doseSee all providers →

$7K

123 claims

$60.18

$32.49

1.9×

Top 10%

0031ATop 10%

COVID-19 vaccine admin, J&J, single dose

$7K

123 claims · 0.0%

Your Cost: $60.18/claim|Median: $32.49

1.9× median

90670 See all providers →

$7K

1,967 claims

$3.32

$5.94

0.6×

Normal range

90670Normal range

$7K

1,967 claims · 0.0%

Your Cost: $3.32/claim|Median: $5.94

0.6× median

99384Preventive visit, new patient, adolescent (12-17 yr)See all providers →

$6K

121 claims

$52.20

$83.63

0.6×

Normal range

99384Normal range

Preventive visit, new patient, adolescent (12-17 yr)

$6K

121 claims · 0.0%

Your Cost: $52.20/claim|Median: $83.63

0.6× median

G2025 See all providers →

$6K

1,071 claims

$5.88

$15.63

0.4×

Normal range

G2025Normal range

$6K

1,071 claims · 0.0%

Your Cost: $5.88/claim|Median: $15.63

0.4× median

99383Preventive visit, new patient, late childhood (5-11 yr)See all providers →

$6K

148 claims

$39.24

$81.92

0.5×

Normal range

99383Normal range

Preventive visit, new patient, late childhood (5-11 yr)

$6K

148 claims · 0.0%

Your Cost: $39.24/claim|Median: $81.92

0.5× median

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

$6K

2,349 claims

$2.46

$57.85

0.0×

Normal range

99203Normal range

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

$6K

2,349 claims · 0.0%

Your Cost: $2.46/claim|Median: $57.85

0.0× median

99212Office/outpatient visit, low complexitySee all providers →

$5K

44K claims

$0.12

$25.06

0.0×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$5K

44K claims · 0.0%

Your Cost: $0.12/claim|Median: $25.06

0.0× median

99211Office/outpatient visit, minimal complexitySee all providers →

$5K

21K claims

$0.25

$12.93

0.0×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$5K

21K claims · 0.0%

Your Cost: $0.25/claim|Median: $12.93

0.0× median

90633 See all providers →

$5K

2,397 claims

$2.11

$3.56

0.6×

Normal range

90633Normal range

$5K

2,397 claims · 0.0%

Your Cost: $2.11/claim|Median: $3.56

0.6× median

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

$4K

1,033 claims

$4.24

$84.03

0.1×

Normal range

99204Normal range

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

$4K

1,033 claims · 0.0%

Your Cost: $4.24/claim|Median: $84.03

0.1× median

99215Office/outpatient visit, high complexitySee all providers →

$4K

6,987 claims

$0.60

$74.09

0.0×

Normal range

99215Normal range

Office/outpatient visit, high complexity

$4K

6,987 claims · 0.0%

Your Cost: $0.60/claim|Median: $74.09

0.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$4K

117 claims

$34.82

$99.21

0.4×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$4K

117 claims · 0.0%

Your Cost: $34.82/claim|Median: $99.21

0.4× median

90651HPV vaccine, 9-valentSee all providers →

$4K

2,999 claims

$1.32

$8.93

0.1×

Normal range

90651Normal range

HPV vaccine, 9-valent

$4K

2,999 claims · 0.0%

Your Cost: $1.32/claim|Median: $8.93

0.1× median

90750 See all providers →

$4K

2,495 claims

$1.48

$96.16

0.0×

Normal range

90750Normal range

$4K

2,495 claims · 0.0%

Your Cost: $1.48/claim|Median: $96.16

0.0× median

90715Tdap vaccineSee all providers →

$3K

3,115 claims

$1.09

$10.32

0.1×

Normal range

90715Normal range

Tdap vaccine

$3K

3,115 claims · 0.0%

Your Cost: $1.09/claim|Median: $10.32

0.1× median

90853Group psychotherapySee all providers →

$3K

248 claims

$10.42

$25.02

0.4×

Normal range

90853Normal range

Group psychotherapy

$3K

248 claims · 0.0%

Your Cost: $10.42/claim|Median: $25.02

0.4× median

90710MMRV vaccineSee all providers →

$3K

649 claims

$3.86

$7.00

0.6×

Normal range

90710Normal range

MMRV vaccine

$3K

649 claims · 0.0%

Your Cost: $3.86/claim|Median: $7.00

0.6× median

99000 See all providers →

$2K

29K claims

$0.08

$2.30

0.0×

Normal range

99000Normal range

$2K

29K claims · 0.0%

Your Cost: $0.08/claim|Median: $2.30

0.0× median

99173 See all providers →

$2K

18K claims

$0.13

$2.16

0.1×

Normal range

99173Normal range

$2K

18K claims · 0.0%

Your Cost: $0.13/claim|Median: $2.16

0.1× median

90681 See all providers →

$2K

384 claims

$5.54

$5.74

1.0×

Normal range

90681Normal range

$2K

384 claims · 0.0%

Your Cost: $5.54/claim|Median: $5.74

1.0× median

90688 See all providers →

$2K

4,350 claims

$0.48

$9.00

0.1×

Normal range

90688Normal range

$2K

4,350 claims · 0.0%

Your Cost: $0.48/claim|Median: $9.00

0.1× median

90716 See all providers →

$2K

551 claims

$3.58

$6.18

0.6×

Normal range

90716Normal range

$2K

551 claims · 0.0%

Your Cost: $3.58/claim|Median: $6.18

0.6× median

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