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

    NPI 1972598449 · 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 194 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
    Address750 S Bascom Ave
    CitySan Jose
    StateCA
    ZIP95128
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedSeptember 12, 2005

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

    Payer SourceTotal Paid
    Medicaid$175.9M
    Medicare$0

    Key Findings

    COUNTY OF SANTA CLARA reports no Medicare billing on file and $175.9M in lifetime Medicaid revenue, making it effectively a single-payer Medicaid operation at scale in the dataset rather than a dual-payer provider. This concentration means analyses of its business mix should treat Medicaid as the dominant—and for practical purposes, sole—payer exposure reported here.

    Revenue is extremely concentrated: the precomputed top 3 Medicaid codes account for 99.3% of this provider's total Medicaid revenue, with T1015 alone representing $173.5M or 98.8% of Medicaid revenue. That level of concentration indicates the provider’s financial footprint is driven overwhelmingly by a single bundled clinic/encounter payment model.

    The code mix and taxonomy (Federally Qualified Health Center) align: T1015 (401.6K claims, $432 avg paid/claim, $173.5M revenue) is an all-inclusive clinic visit/encounter code and dominates billing, which is consistent with an FQHC delivering high-volume, comprehensive primary care encounters rather than fee-for-service specialty procedures. The large claim count (401.6K) plus the high per-claim payment for T1015 suggest clinic-based, visit-focused operations are the core service line.

    Traditional E/M codes appear in very high volumes but contribute little revenue: 99213 shows 228.9K claims at $3 avg paid/claim for $686.6K and 99214 shows 54.5K claims at $4 avg paid/claim for $218K. Both codes rank as extreme outliers in-state (99213 ranks #62 of 14524, 100th percentile; 99214 ranks #185 of 13295, 99th percentile), which indicates heavy use of E/M-level reporting, but the low average paid/claim means they do not materially drive revenue compared with T1015.

    Preventive and pediatric services are prominent in utilization and relative statewide standing: 99392 (39.5K claims, $4 avg, $158K) ranks #4 of 2403 providers (100th percentile) and 99391 (32.7K, $4, $130.8K) ranks #3 of 1954 (100th percentile), while 99393 (20.9K, $5, $104.5K) ranks #16 of 2596 (99th percentile). These high ranks and claim volumes indicate a strong emphasis on well-child and preventive visit capacity within the clinic footprint.

    Public health and ancillary services appear active: immunizations and sexual health testing show meaningful volumes and above-typical state standing — 90651 (HPV vaccine) has 4.8K claims at $16 avg ($76.5K revenue, rank #44 of 1720, 97th percentile), while 87491 and 87591 (Chlamydia and Gonorrhea NAATs) each have 6.6K claims and roughly $46K revenue, ranking in the upper state percentiles. This mix is consistent with FQHCs’ role in preventive and community health services.

    The provider also reports non-visit service activity such as telehealth and care coordination: G0071 (3.4K claims, $7 avg, $23.8K; rank #12 of 313, 96th percentile) indicates use of virtual communication technology for FQHC encounters, while G9008 (492 claims, $156 avg, $76.8K; rank #271 of 492, 45th percentile) and G9012 (600 claims, $75 avg, $45K; rank #431 of 718, 40th percentile) show some billing for coordinated care and case management consistent with population-health functions.

    Competitive standing and tenure: for its dominant codes the provider is a statewide heavyweight—T1015 ranks #28 of 1550 (98th percentile; extreme outlier) and several E/M and preventive codes sit at the 99th–100th percentile—while many ancillary codes are in typical ranges. The NPI was enumerated on 2005-09-12 (~21 years ago), indicating a long-established presence in the region to support the high cumulative claim volumes reported.

    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.

    194 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive401,630$430$173.5M
    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…228,870$1$686.6K
    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…54,510$1$218K
    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,…82,830$1$165.7K
    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…39,510$1$158K
    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…32,710$1$130.8K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.20,910$10$104.5K
    G9008Coordinated care fee, physician coordinated care oversight services490$160$76.8K
    90651This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…4,780$20$76.5K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.6,640$10$46.5K

    Showing 1–10 of 194

    • 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

    194 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive281,55038,050$190$14.1M
    G9012Other specified case management service not elsewhere classified4317201,110$110$651.3K
    G9008Coordinated care fee, physician coordinated care oversight services271490660$70$396.7K
    J7307Etonogestrel (contraceptive) implant system, including implant and supplies202250120$850$378K
    93303The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…90140590$120$350.5K
    99343N/A73030$1,030$327.6K
    99345The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…458080$90$293.3K
    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…1750670$40$282.6K
    87633The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…279290220$210$268.3K
    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…161900560$70$230.3K

    Showing 1–10 of 194

    • 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$132.5M
    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
    County Of Santa ClaraCAMethadone Clinic$107.4K$84.1M
    Premier Healthcare Services, LLCCAHome Health Agency$0$32M
    Physicians Surgery Services LLCCAAmbulatory Surgical Clinic/Center$1.5M$5.4M
    Hossein ShenasaCAInterventional Cardiology Physician$1.2M$0
    Arash PadidarCAVascular & Interventional Radiology Physician$1.1M$0
    Keshav NarainCARetina Specialist (Ophthalmology) Physician$571.9K$0
    Anthony BadameCADermatology Physician$441.3K$0
    Josephine PhamCAInternal Medicine Physician$367.9K$0
    Han LoCAUrology Physician$321.8K$0
    Randal PhamCASpecialist$303.2K$0

    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 — 13 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California