County of Santa Clara
Clinic/Center Emergency Care
San Jose, California
NPI: 1821341298
Risk Tier
Elevated
Total Paid
$106.0M
$105,955,084
Total Claims
34K
Beneficiaries
28K
Avg Cost/Claim
$3,085.11
Statistical Fraud Flags (1)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $3,110.66 per claim for S9484 (Crisis intervention mental health services, per hour), which is 12.5× the national median of $249.51.
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