Is FAMILY HEALTHCARE NETWORK flagged for Medicaid fraud?

FAMILY HEALTHCARE NETWORK (NPI: 1730502725) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does FAMILY HEALTHCARE NETWORK bill Medicaid?

FAMILY HEALTHCARE NETWORK 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 VISALIA, CA.

What is NPI 1730502725?

NPI 1730502725 is the National Provider Identifier for FAMILY HEALTHCARE NETWORK. They are a Clinic/Center, Federally Qualified Health Center (FQHC) provider based in VISALIA, CA. This NPI is registered with the CMS NPI Registry.

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FAMILY HEALTHCARE NETWORK

Clinic/Center, Federally Qualified Health Center (FQHC)·VISALIA, CA·NPI: 1730502725Share

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 $93.5M 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

$93.5M

$93,479,152

Total Claims

1.7M

Beneficiaries

1.3M

1.4 claims/patient

Avg Cost/Claim

$54

Monthly Spending Trend

Yearly Spending

2018

$21.1M

-40%

2019

$12.6M

-5%

2020

$12.0M

+15%

2021

$13.7M

-24%

2022

$10.4M

+11%

2023

$11.6M

+4%

2024

$12.0M

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 71% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$66.5M

483K claims

$137.75

$121.16

1.1×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$66.5M

483K claims · 71.1%

Your Cost: $137.75/claim|Median: $121.16

1.1× median

00003Anesthesia servicesSee all providers →

$23.1M

140K claims

$165.01

$223.77

0.7×

Normal range

00003Normal range

Anesthesia services

$23.1M

140K claims · 24.7%

Your Cost: $165.01/claim|Median: $223.77

0.7× median

92014Ophthalmological exam, comprehensive, established patientSee all providers →

$756K

32K claims

$23.37

$47.08

0.5×

Normal range

92014Normal range

Ophthalmological exam, comprehensive, established patient

$756K

32K claims · 0.8%

Your Cost: $23.37/claim|Median: $47.08

0.5× median

V2020Frames, purchasesSee all providers →

$392K

21K claims

$18.31

$19.33

0.9×

Normal range

V2020Normal range

Frames, purchases

$392K

21K claims · 0.4%

Your Cost: $18.31/claim|Median: $19.33

0.9× median

90791Psychiatric diagnostic evaluationSee all providers →

$386K

10K claims

$38.16

$99.21

0.4×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$386K

10K claims · 0.4%

Your Cost: $38.16/claim|Median: $99.21

0.4× median

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

$356K

225K claims

$1.58

$37.81

0.0×

Normal range

99213Normal range

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

$356K

225K claims · 0.4%

Your Cost: $1.58/claim|Median: $37.81

0.0× median

92340Fitting of spectacles, except for aphakiaSee all providers →

$298K

16K claims

$18.08

$19.46

0.9×

Normal range

92340Normal range

Fitting of spectacles, except for aphakia

$298K

16K claims · 0.3%

Your Cost: $18.08/claim|Median: $19.46

0.9× median

99212Office/outpatient visit, low complexitySee all providers →

$282K

118K claims

$2.39

$25.06

0.1×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$282K

118K claims · 0.3%

Your Cost: $2.39/claim|Median: $25.06

0.1× median

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

$278K

794 claims

$349.64

$66.78

5.2×

Top 10%

G9008Top 10%

Coordination of long-term care services, per month

$278K

794 claims · 0.3%

Your Cost: $349.64/claim|Median: $66.78

5.2× median

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

$244K

1,130 claims

$216.21

$137.85

1.6×

Normal range

G9012Normal range

Other specified case management service, per 15 minutes

$244K

1,130 claims · 0.3%

Your Cost: $216.21/claim|Median: $137.85

1.6× median

90832Psychotherapy, 30 minutesSee all providers →

$221K

13K claims

$16.57

$41.28

0.4×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$221K

13K claims · 0.2%

Your Cost: $16.57/claim|Median: $41.28

0.4× median

92015Determination of refractive stateSee all providers →

$151K

34K claims

$4.42

$10.36

0.4×

Normal range

92015Normal range

Determination of refractive state

$151K

34K claims · 0.2%

Your Cost: $4.42/claim|Median: $10.36

0.4× median

G0467Federally qualified health center visit, mental healthSee all providers →

$99K

3,542 claims

$27.81

$21.91

1.3×

Normal range

G0467Normal range

Federally qualified health center visit, mental health

$99K

3,542 claims · 0.1%

Your Cost: $27.81/claim|Median: $21.91

1.3× median

92341 See all providers →

$85K

3,080 claims

$27.67

$22.77

1.2×

Normal range

92341Normal range

$85K

3,080 claims · 0.1%

Your Cost: $27.67/claim|Median: $22.77

1.2× median

92004Ophthalmological exam, comprehensive, new patientSee all providers →

$47K

517 claims

$90.82

$59.72

1.5×

Top 25%

92004Top 25%

Ophthalmological exam, comprehensive, new patient

$47K

517 claims · 0.1%

Your Cost: $90.82/claim|Median: $59.72

1.5× median

G9920 See all providers →

$41K

15K claims

$2.73

$6.56

0.4×

Normal range

G9920Normal range

$41K

15K claims · 0.0%

Your Cost: $2.73/claim|Median: $6.56

0.4× median

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

$29K

17K claims

$1.68

$69.35

0.0×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$29K

17K claims · 0.0%

Your Cost: $1.68/claim|Median: $69.35

0.0× median

J7307Etonogestrel implant system, including implant and suppliesSee all providers →

$25K

362 claims

$69.66

$786.43

0.1×

Normal range

J7307Normal range

Etonogestrel implant system, including implant and supplies

$25K

362 claims · 0.0%

Your Cost: $69.66/claim|Median: $786.43

0.1× median

59409Vaginal delivery onlySee all providers →

$23K

78 claims

$294.58

$619.91

0.5×

Normal range

59409Normal range

Vaginal delivery only

$23K

78 claims · 0.0%

Your Cost: $294.58/claim|Median: $619.91

0.5× median

J3490Unclassified drugsSee all providers →

$22K

4,498 claims

$4.78

$5.70

0.8×

Normal range

J3490Normal range

Unclassified drugs

$22K

4,498 claims · 0.0%

Your Cost: $4.78/claim|Median: $5.70

0.8× median

H1001 See all providers →

$14K

13K claims

$1.10

$60.48

0.0×

Normal range

H1001Normal range

$14K

13K claims · 0.0%

Your Cost: $1.10/claim|Median: $60.48

0.0× median

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

$13K

198 claims

$67.00

$25.93

2.6×

Top 5%

0011ATop 5%

COVID-19 vaccine admin, Moderna, 1st dose

$13K

198 claims · 0.0%

Your Cost: $67.00/claim|Median: $25.93

2.6× median

92250Fundus photography with interpretation and reportSee all providers →

$12K

3,209 claims

$3.71

$27.95

0.1×

Normal range

92250Normal range

Fundus photography with interpretation and report

$12K

3,209 claims · 0.0%

Your Cost: $3.71/claim|Median: $27.95

0.1× median

99460Initial hospital or birthing center care, newborn, per daySee all providers →

$12K

986 claims

$12.07

$62.48

0.2×

Normal range

99460Normal range

Initial hospital or birthing center care, newborn, per day

$12K

986 claims · 0.0%

Your Cost: $12.07/claim|Median: $62.48

0.2× median

99238Hospital discharge day management, 30 minutes or lessSee all providers →

$11K

1,378 claims

$7.86

$37.22

0.2×

Normal range

99238Normal range

Hospital discharge day management, 30 minutes or less

$11K

1,378 claims · 0.0%

Your Cost: $7.86/claim|Median: $37.22

0.2× median

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

$11K

1,343 claims

$7.92

$73.46

0.1×

Normal range

99381Normal range

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

$11K

1,343 claims · 0.0%

Your Cost: $7.92/claim|Median: $73.46

0.1× median

81025Urine pregnancy testSee all providers →

$11K

39K claims

$0.27

$4.81

0.1×

Normal range

81025Normal range

Urine pregnancy test

$11K

39K claims · 0.0%

Your Cost: $0.27/claim|Median: $4.81

0.1× median

11976 See all providers →

$10K

574 claims

$17.49

$57.06

0.3×

Normal range

11976Normal range

$10K

574 claims · 0.0%

Your Cost: $17.49/claim|Median: $57.06

0.3× median

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

$9K

8,293 claims

$1.12

$53.41

0.0×

Normal range

99214Normal range

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

$9K

8,293 claims · 0.0%

Your Cost: $1.12/claim|Median: $53.41

0.0× median

99239Hospital discharge day management, more than 30 minutesSee all providers →

$8K

684 claims

$11.75

$43.85

0.3×

Normal range

99239Normal range

Hospital discharge day management, more than 30 minutes

$8K

684 claims · 0.0%

Your Cost: $11.75/claim|Median: $43.85

0.3× median

0072A See all providers →

$7K

111 claims

$67.00

$39.57

1.7×

Top 5%

0072ATop 5%

$7K

111 claims · 0.0%

Your Cost: $67.00/claim|Median: $39.57

1.7× median

11981 See all providers →

$7K

309 claims

$21.90

$117.16

0.2×

Normal range

11981Normal range

$7K

309 claims · 0.0%

Your Cost: $21.90/claim|Median: $117.16

0.2× median

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

$6K

4,573 claims

$1.21

$72.71

0.0×

Normal range

99395Normal range

Preventive medicine, established patient, age 18-39

$6K

4,573 claims · 0.0%

Your Cost: $1.21/claim|Median: $72.71

0.0× median

0071A See all providers →

$4K

65 claims

$65.97

$38.71

1.7×

Top 10%

0071ATop 10%

$4K

65 claims · 0.0%

Your Cost: $65.97/claim|Median: $38.71

1.7× median

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

$4K

64 claims

$65.95

$36.70

1.8×

Top 5%

0002ATop 5%

COVID-19 vaccine admin, Pfizer, 2nd dose

$4K

64 claims · 0.0%

Your Cost: $65.95/claim|Median: $36.70

1.8× median

76811Ultrasound, pregnant uterus, detailed, single fetusSee all providers →

$4K

288 claims

$14.59

$106.79

0.1×

Normal range

76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$4K

288 claims · 0.0%

Your Cost: $14.59/claim|Median: $106.79

0.1× median

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

$3K

15K claims

$0.23

$75.18

0.0×

Normal range

99392Normal range

Preventive medicine, established patient, age 1-4

$3K

15K claims · 0.0%

Your Cost: $0.23/claim|Median: $75.18

0.0× median

0004A See all providers →

$3K

52 claims

$65.71

$35.62

1.8×

Top 10%

0004ATop 10%

$3K

52 claims · 0.0%

Your Cost: $65.71/claim|Median: $35.62

1.8× median

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

$3K

49 claims

$65.63

$33.72

1.9×

Top 5%

0001ATop 5%

COVID-19 vaccine admin, Pfizer, 1st dose

$3K

49 claims · 0.0%

Your Cost: $65.63/claim|Median: $33.72

1.9× median

59514Cesarean delivery onlySee all providers →

$3K

12 claims

$257.00

$452.80

0.6×

Normal range

59514Normal range

Cesarean delivery only

$3K

12 claims · 0.0%

Your Cost: $257.00/claim|Median: $452.80

0.6× median

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

$3K

44 claims

$67.00

$33.85

2.0×

Top 5%

0012ATop 5%

COVID-19 vaccine admin, Moderna, 2nd dose

$3K

44 claims · 0.0%

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

2.0× median

H1000Prenatal care, at-risk assessmentSee all providers →

$3K

671 claims

$4.34

$50.36

0.1×

Normal range

H1000Normal range

Prenatal care, at-risk assessment

$3K

671 claims · 0.0%

Your Cost: $4.34/claim|Median: $50.36

0.1× median

G8511 See all providers →

$2K

6,454 claims

$0.34

$0.28

1.2×

Normal range

G8511Normal range

$2K

6,454 claims · 0.0%

Your Cost: $0.34/claim|Median: $0.28

1.2× median

92133 See all providers →

$2K

647 claims

$3.36

$19.09

0.2×

Normal range

92133Normal range

$2K

647 claims · 0.0%

Your Cost: $3.36/claim|Median: $19.09

0.2× median

G2025 See all providers →

$2K

119 claims

$17.39

$15.63

1.1×

Normal range

G2025Normal range

$2K

119 claims · 0.0%

Your Cost: $17.39/claim|Median: $15.63

1.1× median

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

$2K

9,671 claims

$0.20

$74.82

0.0×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$2K

9,671 claims · 0.0%

Your Cost: $0.20/claim|Median: $74.82

0.0× median

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

$2K

146 claims

$11.49

$57.85

0.2×

Normal range

99203Normal range

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

$2K

146 claims · 0.0%

Your Cost: $11.49/claim|Median: $57.85

0.2× median

90670 See all providers →

$1K

10K claims

$0.15

$5.94

0.0×

Normal range

90670Normal range

$1K

10K claims · 0.0%

Your Cost: $0.15/claim|Median: $5.94

0.0× median

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

$1K

5,078 claims

$0.28

$80.15

0.0×

Normal range

99394Normal range

Preventive medicine, established patient, age 12-17

$1K

5,078 claims · 0.0%

Your Cost: $0.28/claim|Median: $80.15

0.0× median

90680 See all providers →

$1K

8,082 claims

$0.17

$5.58

0.0×

Normal range

90680Normal range

$1K

8,082 claims · 0.0%

Your Cost: $0.17/claim|Median: $5.58

0.0× median

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