Adventist Health Physicians Network
Adventist Health Physicians Network was paid $1.21M by Medicaid between Jan 2021 and Oct 2024, across 9 billing codes. Its largest line is 45385, Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) — 43% of everything it billed.
SAINT HELENA, CA 94574
Next to other Case Manager/Care Coordinator providers in California
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2021 | 768 | $152K | |
| 2022 | 1,184 | $255K | |
| 2023 | 1,619 | $345K | |
| 2024incomplete | 1,843 | $459K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 43% | 1,005 | 986 | $520K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 20% | 1,027 | 1,008 | $237K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 18% | 1,057 | 1,023 | $214K |
| 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 | 9.4% | 1,115 | 1,101 | $114K |
| 45381 | 6.4% | 320 | 314 | $78K | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 2.8% | 659 | 626 | $34K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 96 | 95 | $9K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 78 | 77 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 57 | 51 | $2K |
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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.