Physician
Bay Area Pediatric Primary Care INC.
Bay Area Pediatric Primary Care INC. was paid $491K by Medicaid between Apr 2019 and Nov 2024, across 41 billing codes. Its largest line is 99392, Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) — 17% of everything it billed.
33Billing provider infoBAY AREA PEDIATRIC PRIMARY CARE INC.
SAN JOSE, CA 95116
SAN JOSE, CA 95116
33aNPI1013424217assigned 01/09/2018
33bProvider typePediatrics Physician
28Total paid$491K
24GClaims38,706
24DCodes billed41
24AFirst – last monthApr 2019 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in California
Rank by total paid#230 of 1,490
Median peer was paid$15K
This provider vs. median33×
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 | |
|---|---|---|---|
| 2019 | 3,143 | $36K | |
| 2020 | 5,745 | $76K | |
| 2021 | 7,216 | $104K | |
| 2022 | 7,554 | $95K | |
| 2023 | 9,696 | $131K | |
| 2024incomplete | 5,352 | $50K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 17% | 2,749 | 2,745 | $85K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 16% | 2,371 | 2,356 | $78K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 9.4% | 994 | 989 | $46K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.7% | 1,034 | 1,032 | $38K |
| 92552 | 7.6% | 3,383 | 3,380 | $37K | |
| 90686 | 6.9% | 4,170 | 4,160 | $34K | |
| 92081 | 5.1% | 2,546 | 2,545 | $25K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4.6% | 463 | 463 | $23K |
| 90670 | 3.9% | 2,488 | 2,477 | $19K | |
| 90648 | 3.9% | 2,450 | 2,439 | $19K | |
| 90723 | 3.1% | 1,929 | 1,922 | $15K | |
| 90680 | 2.7% | 1,705 | 1,698 | $13K |
29 more codes
| 90633 | 2.0% | 1,299 | $10K | |
| 0071A | <1% | 119 | $5K | |
| 0072A | <1% | 117 | $5K | |
| 90651 | <1% | 446 | $4K | |
| 99223 | Prolong inpt eval add15 m | <1% | 234 | $4K |
| 0001A | <1% | 98 | $4K | |
| 0003A | <1% | 94 | $4K | |
| 90620 | <1% | 316 | $3K | |
| 90716 | <1% | 358 | $3K | |
| 0002A | <1% | 63 | $2K | |
| 90734 | <1% | 266 | $2K | |
| 90707 | <1% | 261 | $2K | |
| 90700 | <1% | 253 | $2K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 228 | $2K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 4,977 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 27 | $2K |
| 0124A | <1% | 26 | $1K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 625 | $1K |
| 99384 | <1% | 12 | $507.64 | |
| 90710 | <1% | 53 | $376.96 | |
| 90696 | <1% | 48 | $338.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 50 | $303.84 |
| 90715 | <1% | 27 | $250.79 | |
| 90657 | <1% | 15 | $140.00 | |
| 90672 | <1% | 14 | $120.00 | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 14 | $45.47 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 2,282 | $0.00 |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 89 | $0.00 |
| 86580 | 0% | 13 | $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 officialMERCADO, JERRY (CEO)