Is ALTAMED HEALTH SERVICES CORP flagged for Medicaid fraud?

ALTAMED HEALTH SERVICES CORP (NPI: 1730481318) 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 WEST COVINA, CA.

What is NPI 1730481318?

NPI 1730481318 is the National Provider Identifier for ALTAMED HEALTH SERVICES CORP. They are a Clinic/Center, Federally Qualified Health Center (FQHC) provider based in WEST COVINA, 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)·WEST COVINA, CA·NPI: 1730481318Share

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 $83.9M 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

$83.9M

$83,897,609

Total Claims

1.5M

Beneficiaries

1.2M

1.3 claims/patient

Avg Cost/Claim

$57

Monthly Spending Trend

Yearly Spending

2018

$9.2M

-4%

2019

$8.9M

+27%

2020

$11.3M

+9%

2021

$12.3M

-2%

2022

$12.0M

+18%

2023

$14.2M

+12%

2024

$15.9M

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 82% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$69.1M

372K claims

$185.48

$121.16

1.5×

Top 25%

T1015Top 25%

Clinic visit/encounter, all-inclusive

$69.1M

372K claims · 82.3%

Your Cost: $185.48/claim|Median: $121.16

1.5× median

00003Anesthesia servicesSee all providers →

$13.4M

52K claims

$259.84

$223.77

1.2×

Normal range

00003Normal range

Anesthesia services

$13.4M

52K claims · 16.0%

Your Cost: $259.84/claim|Median: $223.77

1.2× median

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

$172K

16K claims

$10.96

$75.18

0.1×

Normal range

99392Normal range

Preventive medicine, established patient, age 1-4

$172K

16K claims · 0.2%

Your Cost: $10.96/claim|Median: $75.18

0.1× median

90834Psychotherapy, 45 minutesSee all providers →

$116K

5,064 claims

$22.87

$63.65

0.4×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$116K

5,064 claims · 0.1%

Your Cost: $22.87/claim|Median: $63.65

0.4× median

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

$115K

12K claims

$9.53

$69.35

0.1×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$115K

12K claims · 0.1%

Your Cost: $9.53/claim|Median: $69.35

0.1× median

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

$107K

8,874 claims

$12.08

$74.82

0.2×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$107K

8,874 claims · 0.1%

Your Cost: $12.08/claim|Median: $74.82

0.2× median

96110Developmental screening, per standardized instrumentSee all providers →

$107K

5,211 claims

$20.47

$9.10

2.2×

Top 25%

96110Top 25%

Developmental screening, per standardized instrument

$107K

5,211 claims · 0.1%

Your Cost: $20.47/claim|Median: $9.10

2.2× median

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

$95K

6,340 claims

$14.96

$80.15

0.2×

Normal range

99394Normal range

Preventive medicine, established patient, age 12-17

$95K

6,340 claims · 0.1%

Your Cost: $14.96/claim|Median: $80.15

0.2× median

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

$72K

299K claims

$0.24

$37.81

0.0×

Normal range

99213Normal range

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

$72K

299K claims · 0.1%

Your Cost: $0.24/claim|Median: $37.81

0.0× median

G9920 See all providers →

$57K

7,126 claims

$8.06

$6.56

1.2×

Normal range

G9920Normal range

$57K

7,126 claims · 0.1%

Your Cost: $8.06/claim|Median: $6.56

1.2× median

90791Psychiatric diagnostic evaluationSee all providers →

$50K

1,403 claims

$35.97

$99.21

0.4×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$50K

1,403 claims · 0.1%

Your Cost: $35.97/claim|Median: $99.21

0.4× median

90832Psychotherapy, 30 minutesSee all providers →

$37K

2,623 claims

$14.08

$41.28

0.3×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$37K

2,623 claims · 0.0%

Your Cost: $14.08/claim|Median: $41.28

0.3× median

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

$31K

19K claims

$1.60

$7.18

0.2×

Normal range

90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$31K

19K claims · 0.0%

Your Cost: $1.60/claim|Median: $7.18

0.2× median

90670 See all providers →

$23K

8,893 claims

$2.56

$5.94

0.4×

Normal range

90670Normal range

$23K

8,893 claims · 0.0%

Your Cost: $2.56/claim|Median: $5.94

0.4× median

G0467Federally qualified health center visit, mental healthSee all providers →

$22K

1,031 claims

$21.19

$21.91

1.0×

Normal range

G0467Normal range

Federally qualified health center visit, mental health

$22K

1,031 claims · 0.0%

Your Cost: $21.19/claim|Median: $21.91

1.0× median

83655 See all providers →

$22K

6,832 claims

$3.18

$10.49

0.3×

Normal range

83655Normal range

$22K

6,832 claims · 0.0%

Your Cost: $3.18/claim|Median: $10.49

0.3× median

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

$22K

36K claims

$0.60

$17.85

0.0×

Normal range

90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$22K

36K claims · 0.0%

Your Cost: $0.60/claim|Median: $17.85

0.0× median

90680 See all providers →

$21K

6,241 claims

$3.31

$5.58

0.6×

Normal range

90680Normal range

$21K

6,241 claims · 0.0%

Your Cost: $3.31/claim|Median: $5.58

0.6× median

90633 See all providers →

$18K

5,915 claims

$3.11

$3.56

0.9×

Normal range

90633Normal range

$18K

5,915 claims · 0.0%

Your Cost: $3.11/claim|Median: $3.56

0.9× median

90698 See all providers →

$18K

4,234 claims

$4.25

$6.32

0.7×

Normal range

90698Normal range

$18K

4,234 claims · 0.0%

Your Cost: $4.25/claim|Median: $6.32

0.7× median

90651HPV vaccine, 9-valentSee all providers →

$16K

3,915 claims

$4.20

$8.93

0.5×

Normal range

90651Normal range

HPV vaccine, 9-valent

$16K

3,915 claims · 0.0%

Your Cost: $4.20/claim|Median: $8.93

0.5× median

99212Office/outpatient visit, low complexitySee all providers →

$16K

92K claims

$0.17

$25.06

0.0×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$16K

92K claims · 0.0%

Your Cost: $0.17/claim|Median: $25.06

0.0× median

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

$16K

292 claims

$53.51

$36.70

1.5×

Top 10%

0002ATop 10%

COVID-19 vaccine admin, Pfizer, 2nd dose

$16K

292 claims · 0.0%

Your Cost: $53.51/claim|Median: $36.70

1.5× median

87426SARS-CoV-2 COVID-19 antigen detection, immunoassaySee all providers →

$15K

15K claims

$0.99

$30.04

0.0×

Normal range

87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$15K

15K claims · 0.0%

Your Cost: $0.99/claim|Median: $30.04

0.0× median

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

$15K

278 claims

$52.36

$33.72

1.6×

Top 10%

0001ATop 10%

COVID-19 vaccine admin, Pfizer, 1st dose

$15K

278 claims · 0.0%

Your Cost: $52.36/claim|Median: $33.72

1.6× median

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

$12K

3,960 claims

$2.90

$72.71

0.0×

Normal range

99395Normal range

Preventive medicine, established patient, age 18-39

$12K

3,960 claims · 0.0%

Your Cost: $2.90/claim|Median: $72.71

0.0× median

G0071 See all providers →

$11K

2,645 claims

$4.03

$7.20

0.6×

Normal range

G0071Normal range

$11K

2,645 claims · 0.0%

Your Cost: $4.03/claim|Median: $7.20

0.6× median

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

$9K

33K claims

$0.28

$53.41

0.0×

Normal range

99214Normal range

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

$9K

33K claims · 0.0%

Your Cost: $0.28/claim|Median: $53.41

0.0× median

90697 See all providers →

$9K

3,859 claims

$2.31

$7.24

0.3×

Normal range

90697Normal range

$9K

3,859 claims · 0.0%

Your Cost: $2.31/claim|Median: $7.24

0.3× median

90744 See all providers →

$8K

2,870 claims

$2.95

$5.00

0.6×

Normal range

90744Normal range

$8K

2,870 claims · 0.0%

Your Cost: $2.95/claim|Median: $5.00

0.6× median

90716 See all providers →

$8K

1,318 claims

$6.37

$6.18

1.0×

Normal range

90716Normal range

$8K

1,318 claims · 0.0%

Your Cost: $6.37/claim|Median: $6.18

1.0× median

90734 See all providers →

$8K

1,441 claims

$5.75

$6.40

0.9×

Normal range

90734Normal range

$8K

1,441 claims · 0.0%

Your Cost: $5.75/claim|Median: $6.40

0.9× median

85018 See all providers →

$8K

18K claims

$0.46

$1.71

0.3×

Normal range

85018Normal range

$8K

18K claims · 0.0%

Your Cost: $0.46/claim|Median: $1.71

0.3× median

90461Immunization admin, additional vaccine, counselingSee all providers →

$8K

28K claims

$0.27

$6.93

0.0×

Normal range

90461Normal range

Immunization admin, additional vaccine, counseling

$8K

28K claims · 0.0%

Your Cost: $0.27/claim|Median: $6.93

0.0× median

90707MMR vaccineSee all providers →

$6K

1,161 claims

$5.54

$5.76

1.0×

Normal range

90707Normal range

MMR vaccine

$6K

1,161 claims · 0.0%

Your Cost: $5.54/claim|Median: $5.76

1.0× median

99396Preventive medicine, established patient, age 40-64See all providers →

$6K

2,394 claims

$2.44

$76.06

0.0×

Normal range

99396Normal range

Preventive medicine, established patient, age 40-64

$6K

2,394 claims · 0.0%

Your Cost: $2.44/claim|Median: $76.06

0.0× median

90700 See all providers →

$6K

1,173 claims

$4.79

$4.56

1.0×

Normal range

90700Normal range

$6K

1,173 claims · 0.0%

Your Cost: $4.79/claim|Median: $4.56

1.0× median

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

$5K

1,143 claims

$4.50

$6.61

0.7×

Normal range

92551Normal range

Screening audiometry, pure tone, air only

$5K

1,143 claims · 0.0%

Your Cost: $4.50/claim|Median: $6.61

0.7× median

90677 See all providers →

$5K

2,333 claims

$2.11

$12.96

0.2×

Normal range

90677Normal range

$5K

2,333 claims · 0.0%

Your Cost: $2.11/claim|Median: $12.96

0.2× median

90710MMRV vaccineSee all providers →

$5K

1,142 claims

$4.14

$7.00

0.6×

Normal range

90710Normal range

MMRV vaccine

$5K

1,142 claims · 0.0%

Your Cost: $4.14/claim|Median: $7.00

0.6× median

90696DTaP-IPV vaccineSee all providers →

$5K

886 claims

$5.23

$5.95

0.9×

Normal range

90696Normal range

DTaP-IPV vaccine

$5K

886 claims · 0.0%

Your Cost: $5.23/claim|Median: $5.95

0.9× median

90715Tdap vaccineSee all providers →

$4K

3,088 claims

$1.46

$10.32

0.1×

Normal range

90715Normal range

Tdap vaccine

$4K

3,088 claims · 0.0%

Your Cost: $1.46/claim|Median: $10.32

0.1× median

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

$4K

821 claims

$5.14

$73.46

0.1×

Normal range

99381Normal range

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

$4K

821 claims · 0.0%

Your Cost: $5.14/claim|Median: $73.46

0.1× median

87811SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-readSee all providers →

$4K

7,791 claims

$0.54

$30.53

0.0×

Normal range

87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$4K

7,791 claims · 0.0%

Your Cost: $0.54/claim|Median: $30.53

0.0× median

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

$4K

79 claims

$51.89

$33.85

1.5×

Top 10%

0012ATop 10%

COVID-19 vaccine admin, Moderna, 2nd dose

$4K

79 claims · 0.0%

Your Cost: $51.89/claim|Median: $33.85

1.5× median

D1120Prophylaxis, adultSee all providers →

$4K

2,695 claims

$1.48

$33.86

0.0×

Normal range

D1120Normal range

Prophylaxis, adult

$4K

2,695 claims · 0.0%

Your Cost: $1.48/claim|Median: $33.86

0.0× median

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

$4K

4,226 claims

$0.92

$40.11

0.0×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$4K

4,226 claims · 0.0%

Your Cost: $0.92/claim|Median: $40.11

0.0× median

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

$4K

139 claims

$26.74

$83.63

0.3×

Normal range

99384Normal range

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

$4K

139 claims · 0.0%

Your Cost: $26.74/claim|Median: $83.63

0.3× median

90619 See all providers →

$4K

708 claims

$5.10

$8.36

0.6×

Normal range

90619Normal range

$4K

708 claims · 0.0%

Your Cost: $5.10/claim|Median: $8.36

0.6× median

90656 See all providers →

$4K

2,977 claims

$1.19

$8.67

0.1×

Normal range

90656Normal range

$4K

2,977 claims · 0.0%

Your Cost: $1.19/claim|Median: $8.67

0.1× median

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