Five people were arrested and charged on Tuesday with conducting a health insurance fraud scheme that involved patients at a pair of medical spas in the San Fernando Valley.

Roshanak “Roxanne” or “Roxy” Khadem, a Sherman Oaks resident and owner and operator of the now-shuttered R&R Med Spa in Valley Village and Nu-Me Aesthetic and Anti-Aging Center in Woodland Hills, is accused of enticing patients to receive free cosmetic procedures that were not covered by health insurance. The treatments included Botox injections, facials and laser hair removal.

She and four co-conspirators are alleged to have obtained insurance information from the patients and billed the insurance companies for the services using fraudulent billing codes. In some cases, insurers were billed for services never provided. Over the course of six years, Khadem and the other conspirators made $20 million in claims to insurance companies, which paid out $8 million, the indictment said.

The other four individuals charged are Dr. Roberto Mariano, a physician from Rancho Cucamonga; Marina Sarkisyan of Panorama City, who served as office manager at the clinics; North Hills resident Lucine Ilangezyan, who was an insurance biller for the clinics; and Gary Jizmejian of Santa Clarita. Jizmejian was previously a senior fraud investigator at Anthem Inc., an insurance and health benefits company.

In a federal grand jury indictment unsealed Tuesday, all five defendants were charged with one count of conspiracy to commit health care fraud and 13 counts of health care fraud. Each count carries a maximum sentence of 10 years in prison.

The case was investigated by the United States Department of Labor and the Office of Personnel Management. Anthem Blue Cross has cooperated with the investigation.