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    OpenPayerNPI Medicare & MedicaidCounty Of Santa Clara
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    County Of Santa Clara — Billing Profile & Reimbursement Data

    NPI 1326033929 · San Jose, CA · Federally Qualified Health Center (FQHC)

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    County Of Santa Clara is a federally qualified health center (fqhc) provider located in San Jose, California. This profile covers 0 Medicare and 202 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCounty Of Santa Clara
    Address1993 Mckee Rd
    CitySan Jose
    StateCA
    ZIP95116
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedSeptember 20, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$132.5M
    Medicare$0

    Key Findings

    This provider is effectively single-payer in the Medicare/Medicaid mix: Medicare revenue is listed as none while total Medicaid revenue is $132.5M, so all billed public-payer activity on file is concentrated in Medicaid. This makes Medicaid the dominant and only recorded government payer for COUNTY OF SANTA CLARA in the available data.

    Revenue is extremely concentrated in a handful of Medicaid codes: the top three Medicaid codes account for 98.4% of this provider's total Medicaid revenue, with T1015 generating $123.1M (93.1%), 00003 generating $5.8M (4.3%), and G0467 generating $1.2M (0.9%). That concentration indicates the organization’s financial profile is heavily dependent on a single all-inclusive clinic visit code plus two FQHC-related visit codes.

    The code mix and descriptions are consistent with an FQHC primary-care and preventive-services model: T1015 (all-inclusive clinic visit) dominates revenue, and G0467 (FQHC visit, established patient) is also present, reflecting bundled, per-visit FQHC reimbursement. High volumes in pediatric and preventive visit codes (99391, 99392, 99393, 99394) and numerous immunization codes support a service line focused on routine primary care, well visits, vaccinations, and population health activities.

    COUNTY OF SANTA CLARA is a major statewide participant for its primary revenue driver: T1015 ranks #69 of 1550 providers in-state (96th percentile; notably above typical state volume for this code), indicating it is a leading biller of that FQHC all-inclusive visit in California. By contrast, 00003 ranks #407 of 688 (41th percentile; typical, unremarkable volume) and G0467 ranks #109 of 1029 (89th percentile; typical, unremarkable volume), showing the provider’s dominance is concentrated specifically around T1015.

    Operational throughput is very high for basic E/M and preventive encounters: 99213 (225.3K claims) ranks #64 of 14524 providers in-state (100th percentile; extreme outlier), 99214 (55.3K claims) ranks #175 of 13295 (99th percentile; extreme outlier), and 99212 (64.7K claims) ranks #63 of 5602 (99th percentile; extreme outlier). These are low-dollar-per-claim items (e.g., $3 avg paid/claim for 99213) but the exceptionally large claim volumes point to very high visit volumes and throughput across primary care services.

    Preventive and pediatric services appear to be a significant operational focus: 99392, 99391, 99393, and 99394 each rank in the 99th percentile for in-state providers (examples: 99392 ranks #18 of 2403; 99391 ranks #18 of 1954), and vaccine codes such as 90651 and 90686 also rank at the 99th percentile. This pattern, together with large counts for vaccine administration and A1C/lipid testing (e.g., 83036 ranks #93 of 2390; 80061 ranks #161 of 1605), is consistent with broad preventive-care and chronic-disease monitoring activity typical of a large FQHC.

    The provider uses non–face-to-face and care-coordination services at scale but they are not the primary revenue drivers: G0071 (telehealth/remote evaluation) shows 4.2K claims and $25K revenue and ranks #7 of 313 (98th percentile; notably above typical state volume for this code), while G9008 (coordinated care fee) contributes $263.8K and ranks #196 of 492 (60th percentile; typical, unremarkable volume). This indicates meaningful adoption of telecommunication-based encounters and some care coordination reimbursement alongside the dominant visit bundles.

    County tenure and select service outliers underscore an established, broad program: the NPI was enumerated 2005-09-20 (~21 years ago), reflecting long-standing operation as an FQHC, and the provider is an extreme outlier on several procedure volumes such as 99188 (rank #1 of 627; 100th percentile; extreme outlier) and multiple preventive visit codes. Taken together, long tenure plus concentrated Medicaid revenue and multiple high-percentile service lines indicate a large, mature FQHC-focused Medicaid provider within California.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    202 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive294,540$420$123.1M
    00003N/A11,000$520$5.8M
    G0467Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…7,720$150$1.2M
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…225,260$1$675.8K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…55,280$10$331.7K
    G9008Coordinated care fee, physician coordinated care oversight services1,340$200$263.8K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…64,740$1$129.5K
    87635Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…11,040$10$121.5K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…25,120$1$100.5K
    99391Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…18,240$1$72.9K

    Showing 1–10 of 202

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. California median

    202 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive691,55038,050$190$14.1M
    00003N/A40769014,940$260$7.7M
    G9012Other specified case management service not elsewhere classified3587201,110$110$651.3K
    G9008Coordinated care fee, physician coordinated care oversight services196490660$70$396.7K
    81513The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and…3350670$40$282.6K
    77067The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…324900560$70$230.3K
    0241UN/A141210500$90$226K
    G0467Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…1091,0301,050$70$219.7K
    87591The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.2011,140530$20$195.6K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.2001,270450$20$183.5K

    Showing 1–10 of 202

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with County Of Santa Clara, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    County Of Santa ClaraCACommunity/Behavioral Health Agency$0$1.7B
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$175.9M
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$127.9M
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$106.6M
    County Of Santa ClaraCAEmergency Care Clinic/Center$0$106M
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$102M
    County Of Santa ClaraCAGeneral Acute Care Hospital$0$94.7M
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$70.5M
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$65.3M
    County Of Santa ClaraCAFederally Qualified Health Center (FQHC)$0$53.8M

    Nearby Providers

    Other providers in the same ZIP code as County Of Santa Clara, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Adrian MaCACardiovascular Disease Physician$1M$194.6K
    Shahid SiddiquiCASpecialist$584.2K$60.5K
    Ngoc NguyenCAOphthalmology Physician$563.4K$0
    Lan NguyenCASpecialist$379.5K$0
    Fook WongCAOrthopaedic Surgery Physician$246.3K$0
    Thomas LeiCAPulmonary Disease Physician$229K$14.9K
    Hector CervantesCAFoot & Ankle Surgery Podiatrist$212.9K$2.1K
    Thirupathi ReddyCAInternal Medicine Physician$200.6K$0
    Khoi LamCAEmergency Medicine Physician$191.4K$0
    Charlene LeeCAHematology & Oncology Physician$146.5K$220

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. California Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. California Distribution
    County Of Santa Clara — 15 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California