Physician
Ramona Specialists, INC.
Ramona Specialists, INC. was paid $4.64M by Medicaid between Jan 2018 and Oct 2024, across 41 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 30% of everything it billed.
33Billing provider infoRAMONA SPECIALISTS, INC.
SAN JACINTO, CA 92583
SAN JACINTO, CA 92583
33aNPI1013140276assigned 09/03/2009
33bProvider typePulmonary Disease Physician
28Total paid$4.64M
24GClaims97,385
24DCodes billed41
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in California
Rank by total paid#4 of 225
Median peer was paid$53K
This provider vs. median87×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 11,102 | $723K | |
| 2019 | 12,828 | $724K | |
| 2020 | 12,897 | $742K | |
| 2021 | 11,658 | $668K | |
| 2022 | 13,396 | $631K | |
| 2023 | 20,774 | $619K | |
| 2024incomplete | 14,730 | $529K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 30% | 14,346 | 3,049 | $1.39M |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 17% | 20,403 | 5,283 | $785K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 13% | 11,287 | 11,091 | $603K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 9.3% | 13,191 | 1,797 | $430K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 5.5% | 750 | 740 | $256K |
| 99223 | Prolong inpt eval add15 m | 4.3% | 3,101 | 2,955 | $199K |
| 95811 | 3.5% | 452 | 445 | $161K | |
| 99205 | Prolong outpt/office vis | 3.0% | 1,817 | 1,811 | $137K |
| 94729 | 2.8% | 3,171 | 3,160 | $131K | |
| 94060 | 2.7% | 3,168 | 3,157 | $123K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.3% | 1,771 | 1,765 | $108K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 2.3% | 5,949 | 338 | $105K |
29 more codes
| 94727 | 2.2% | 3,170 | $102K | |
| 99214 | Doctor's office visit, returning patient (more involved) | 1.5% | 3,622 | $70K |
| 94760 | <1% | 2,876 | $14K | |
| 95831 | <1% | 966 | $13K | |
| 99292 | <1% | 96 | $5K | |
| 94375 | <1% | 332 | $3K | |
| 94200 | <1% | 328 | $2K | |
| 90674 | <1% | 24 | $646.99 | |
| 90756 | <1% | 21 | $498.60 | |
| 94618 | <1% | 12 | $257.87 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 41 | $176.80 |
| G9695 | Long-acting inhaled bronchodilator prescribed | <1% | 308 | $0.01 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 636 | $0.01 |
| 3023F | <1% | 859 | $0.01 | |
| 1123F | 0% | 525 | $0.00 | |
| 1036F | 0% | 1,569 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 162 | $0.00 |
| G8839 | Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness | 0% | 509 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 26 | $0.00 |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 135 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 13 | $0.00 |
| G9906 | Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) | 0% | 13 | $0.00 |
| 4040F | 0% | 417 | $0.00 | |
| 1090F | 0% | 308 | $0.00 | |
| G8842 | Apnea hypopnea index (ahi), respiratory disturbance index (rdi) or respiratory event index (rei) documented or measured within 2 months after initial evaluation for suspected obstructive sleep apnea | 0% | 507 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 245 | $0.00 |
| 4004F | 0% | 48 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 162 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 49 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGUPTA, RAKESH (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Ave P Medical PC | Brooklyn, NY | $175K |
| Progressive Cardiovascular Care P.C. | Queens Village, NY | $8K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.