Barrio Comprehensive Family Health Care Center, Inc.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $5.6M (2020) to $27.5M (2021) — a 387% swing with $21.8M absolute change.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $54.70 per claim for 90619 — 6.5× the national median of $8.36.
Bills $39.49 per claim for 90620 — 6.1× the national median of $6.49.
Bills $40.01 per claim for 87804 (Influenza virus detection, rapid test) — 3.2× the national median of $12.59.
Billing above the 90th percentile for 4 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center, Multi-Specialty Peers
Total spending distribution among 12 providers in this specialty
This provider's total spending of $148.0M is at the 50th percentile among 12 Clinic/Center, Multi-Specialty providers.
Total Paid
$148.0M
$148,046,905
Total Claims
2.3M
Beneficiaries
1.9M
1.2 claims/patient
Avg Cost/Claim
$64
#729 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
Barrio Comprehensive Family Health Care Center, Inc. is a Clinic/Center, Multi-Specialty provider based in San Antonio, TX. From the 2018–2024 period, this provider received $148.0M in Medicaid payments across 2.3M claims.
Why This Matters
This provider received $148.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 18,505 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 53% of total spending.
$77.9M
827K claims
$94.22
$121.16
Clinic visit/encounter, all-inclusive
$77.9M
827K claims · 52.6%
$22.0M
327K claims
$67.34
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$22.0M
327K claims · 14.9%
$7.9M
121K claims
$64.91
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$7.9M
121K claims · 5.3%
$5.9M
99K claims
$59.70
$25.06
Office/outpatient visit, low complexity
$5.9M
99K claims · 4.0%
$5.8M
45K claims
$130.06
$101.33
Unspecified diagnostic procedure, by report
$5.8M
45K claims · 3.9%
$4.5M
54K claims
$83.33
$75.18
Preventive medicine, established patient, age 1-4
$4.5M
54K claims · 3.0%
$4.4M
50K claims
$86.97
$69.35
Preventive medicine, established patient, infant (under 1)
$4.4M
50K claims · 2.9%
$3.5M
41K claims
$85.15
$74.82
Preventive medicine, established patient, age 5-11
$3.5M
41K claims · 2.3%
$2.3M
29K claims
$80.49
$80.15
Preventive medicine, established patient, age 12-17
$2.3M
29K claims · 1.6%
Psychotherapy, 30 minutes
$2.0M
28K claims · 1.3%
$1.2M
12K claims
$101.30
$73.46
Preventive visit, new patient, infant (<1 yr)
$1.2M
12K claims · 0.8%
$1.0M
1K claims
$698.77
$786.43
Etonogestrel implant system, including implant and supplies
$1.0M
1K claims · 0.7%
$945K
29K claims
$32.08
$38.83
Psychotherapy, 30 min, add-on to E/M service
$945K
29K claims · 0.6%
Vaginal delivery only
$932K
2K claims · 0.6%
$648K
10K claims
$64.11
$57.85
Office/outpatient visit, new patient, low-mod complexity
$648K
10K claims · 0.4%
$636K
7K claims
$94.73
$81.92
Preventive visit, new patient, late childhood (5-11 yr)
$636K
7K claims · 0.4%
Cesarean delivery only
$575K
1K claims · 0.4%
$515K
7K claims
$71.08
$72.71
Preventive medicine, established patient, age 18-39
$515K
7K claims · 0.3%
Psychiatric diagnostic evaluation
$444K
5K claims · 0.3%
$441K
5K claims
$96.69
$79.89
Preventive visit, new patient, early childhood (1-4 yr)
$441K
5K claims · 0.3%
$404K
5K claims
$88.23
$83.63
Preventive visit, new patient, adolescent (12-17 yr)
$404K
5K claims · 0.3%
$381K
6K claims
$67.95
$84.03
Office/outpatient visit, new patient, mod-high complexity
$381K
6K claims · 0.3%
$316K
6K claims · 0.2%
$245K
3K claims
$92.55
$108.91
Psychiatric diagnostic evaluation with medical services
$245K
3K claims · 0.2%
$197K
5K claims · 0.1%
Influenza virus detection, rapid test
$167K
4K claims · 0.1%
$163K
362 claims · 0.1%
$159K
2K claims
$70.62
$76.22
Preventive visit, new patient, 18-39 yr
$159K
2K claims · 0.1%
$152K
2K claims
$81.51
$74.09
Office/outpatient visit, high complexity
$152K
2K claims · 0.1%
$140K
2K claims
$66.65
$40.11
Office/outpatient visit, new patient, low complexity
$140K
2K claims · 0.1%
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