Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Sutter Bay Medical Foundation

Sutter Bay Medical Foundation was paid $19.65M by Medicaid between Jan 2018 and Dec 2024, across 309 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 19% of everything it billed.

33Billing provider infoSUTTER BAY MEDICAL FOUNDATION
PALO ALTO, CA 94301
33aNPI1013950807assigned 06/13/2006
28Total paid$19.65M
24GClaims838,751
24DCodes billed309
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Clinical Medical Laboratory providers in California

Rank by total paid#46 of 561
Median peer was paid$222K
This provider vs. median89×

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.

Entity ProliferationAuthorized official LOPES, KRISTA controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$200K$400K2018201920202021202220232024
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
YearClaimsPaid
2018119,813$2.89M
2019110,638$2.67M
202099,656$2.20M
2021139,679$3.34M
2022130,467$3.06M
2023148,189$3.22M
2024incomplete90,309$2.27M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 19% 78,954 75,120 $3.66M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6.9% 44,665 42,600 $1.36M
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 6.4% 15,590 14,629 $1.25M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 3.8% 14,790 5,989 $743K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3.0% 9,978 8,692 $591K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 2.3% 10,467 10,033 $448K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 2.2% 10,227 9,803 $437K
90961 2.2% 3,107 3,104 $433K
80053 Comprehensive metabolic panel 2.0% 44,897 41,368 $399K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 2.0% 15,440 15,311 $396K
86481 1.9% 4,224 4,206 $375K
80061 Lipid panel 1.9% 34,141 33,950 $369K
297 more codes
84443 Thyroid stimulating hormone (TSH) 1.7% 23,597 $330K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1.5% 45,487 $301K
77067 Screening mammography, bilateral, including computer-aided detection 1.5% 2,177 $295K
99215 Doctor's office visit, returning patient (complex) 1.4% 5,145 $282K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 1.4% 1,213 $270K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 1.3% 1,728 $264K
83036 Hemoglobin; glycosylated (A1C) 1.3% 33,413 $258K
67028 Intravitreal injection of a pharmacologic agent 1.2% 2,150 $244K
86003 1.1% 1,612 $221K
59425 1.1% 2,930 $221K
88305 Level IV - Surgical pathology, gross and microscopic examination 1.1% 5,023 $219K
99232 Hospital visit by a doctor, follow-up day 1.1% 5,888 $218K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 6,216 $173K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 3,939 $166K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 1,380 $165K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 4,606 $152K
99223 Prolong inpt eval add15 m <1% 1,782 $151K
90686 <1% 8,850 $146K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 2,126 $142K
87480 <1% 5,883 $137K
87510 <1% 5,804 $136K
87660 <1% 5,710 $133K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV <1% 813 $128K
90834 Psychotherapy session, about 45 minutes <1% 2,135 $122K
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 <1% 5,370 $117K
95117 <1% 9,207 $117K
86803 <1% 6,835 $116K
77063 Screening digital breast tomosynthesis, bilateral <1% 3,824 $114K
87086 Culture, bacterial; quantitative colony count, urine <1% 15,449 $113K
71046 Radiologic examination, chest; 2 views <1% 4,891 $106K
93000 <1% 9,460 $106K
80048 Basic metabolic panel (calcium, ionized) <1% 17,080 $101K
99239 Hospital discharge day management, more than 30 minutes <1% 1,850 $99K
82728 <1% 8,051 $87K
99244 Office or other outpatient consultation, moderate to high complexity <1% 423 $80K
0002A <1% 1,953 $76K
90837 Psychotherapy session, about an hour <1% 846 $75K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,392 $75K
91322 <1% 701 $75K
0001A <1% 2,005 $72K
84439 <1% 8,104 $70K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 1,140 $67K
84153 <1% 4,082 $64K
92134 <1% 3,691 $62K
85027 <1% 12,181 $61K
83970 <1% 3,016 $55K
86480 <1% 775 $53K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 5,260 $53K
82570 <1% 13,575 $52K
83550 <1% 7,502 $52K
87186 <1% 6,271 $51K
81001 <1% 19,804 $47K
83540 <1% 7,884 $45K
90791 Psychiatric diagnostic evaluation <1% 479 $44K
J0178 Injection, aflibercept, 1 mg <1% 59 $44K
80076 <1% 6,544 $43K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms <1% 837 $43K
86140 <1% 8,205 $43K
0012A <1% 1,362 $42K
87081 <1% 5,358 $41K
87077 <1% 5,446 $41K
0011A <1% 1,816 $40K
87070 <1% 3,928 $38K
82607 <1% 5,054 $37K
90480 <1% 1,088 $35K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 799 $33K
J0585 Injection, onabotulinumtoxina, 1 unit <1% 48 $33K
82043 <1% 8,795 $33K
87340 <1% 2,728 $33K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 1,679 $29K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 165 $28K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 307 $27K
86592 <1% 5,088 $27K
93296 <1% 1,664 $27K
83735 <1% 4,168 $27K
82274 <1% 1,689 $26K
99204 Doctor's office visit, new patient (more involved) <1% 459 $25K
86765 <1% 1,740 $25K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism <1% 336 $25K
82746 <1% 1,950 $25K
86038 <1% 1,982 $25K
80081 <1% 235 $25K
86160 <1% 920 $22K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 294 $22K
86706 <1% 1,641 $22K
83690 <1% 3,170 $21K
90832 Psychotherapy session, about 30 minutes <1% 475 $20K
83880 <1% 1,328 $20K
83525 <1% 1,241 $19K
85610 <1% 4,994 $19K
99152 <1% 879 $19K
82784 <1% 2,384 $19K
82785 <1% 812 $18K
93970 <1% 311 $18K
91321 <1% 169 $18K
82565 <1% 4,038 $17K
84481 <1% 915 $16K
84460 <1% 3,292 $16K
99243 <1% 132 $16K
85652 <1% 6,563 $16K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 157 $15K
78815 Positron emission tomography (PET) for limited area imaging <1% 18 $15K
90656 <1% 792 $15K
84156 <1% 4,726 $15K
73630 <1% 646 $15K
84100 <1% 3,068 $14K
99000 <1% 2,903 $14K
82670 <1% 410 $14K
99203 Doctor's office visit, new patient (routine) <1% 407 $14K
83516 <1% 983 $13K
92557 <1% 463 $13K
90962 <1% 120 $13K
92550 <1% 1,006 $13K
99254 <1% 177 $13K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes <1% 380 $12K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B <1% 70 $12K
84550 <1% 3,626 $11K
0064A <1% 284 $11K
86762 <1% 623 $11K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 162 $10K
0071A <1% 255 $10K
0124A <1% 269 $10K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose <1% 90 $10K
82947 <1% 2,659 $10K
99308 Subsequent nursing facility care, per day, straightforward <1% 516 $9K
82533 <1% 550 $9K
87400 <1% 852 $9K
84450 <1% 1,565 $9K
99238 Hospital discharge day management, 30 minutes or less <1% 226 $9K
86735 <1% 535 $9K
0072A <1% 213 $8K
87045 <1% 748 $8K
90662 <1% 770 $8K
81003 <1% 4,050 $8K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 63 $8K
99173 <1% 1,243 $8K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 611 $7K
82550 <1% 1,497 $7K
85651 <1% 1,718 $7K
87147 <1% 971 $7K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 98 $7K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 211 $7K
83001 <1% 286 $6K
93294 <1% 595 $6K
87634 <1% 72 $6K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 310 $6K
84165 <1% 964 $6K
97139 <1% 294 $6K
84403 <1% 322 $6K
97810 <1% 244 $6K
97811 <1% 242 $6K
87205 <1% 1,468 $6K
0134A <1% 170 $6K
86376 <1% 331 $6K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 55 $6K
93750 <1% 81 $5K
93015 <1% 93 $5K
93248 <1% 195 $5K
86364 <1% 427 $5K
80069 <1% 1,997 $5K
99205 Prolong outpt/office vis <1% 133 $5K
95115 <1% 505 $5K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 113 $5K
87046 <1% 770 $5K
93295 <1% 89 $5K
85007 <1% 1,592 $4K
84484 <1% 469 $4K
86431 <1% 761 $4K
80197 <1% 242 $4K
86787 <1% 260 $4K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 87 $4K
86258 <1% 336 $4K
92551 <1% 421 $4K
0004A <1% 100 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,087 $4K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 44 $4K
83615 <1% 584 $4K
87088 <1% 525 $4K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 505 $3K
95144 <1% 26 $3K
90694 <1% 535 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 426 $3K
90792 Psychiatric diagnostic evaluation with medical services <1% 26 $3K
73610 <1% 117 $3K
92015 Determination of refractive state <1% 275 $3K
94010 <1% 77 $3K
93990 <1% 78 $3K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 422 $3K
82951 <1% 152 $3K
20610 <1% 188 $2K
85730 <1% 306 $2K
86665 <1% 65 $2K
93246 <1% 158 $2K
95813 <1% 41 $2K
82105 <1% 141 $2K
93351 <1% 20 $2K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries <1% 13 $2K
92567 <1% 98 $2K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 159 $2K
J2785 Injection, regadenoson, 0.1 mg <1% 16 $2K
86704 <1% 135 $2K
59025 Fetal non-stress test <1% 55 $2K
82248 <1% 340 $2K
90653 <1% 252 $2K
76642 <1% 45 $2K
81025 <1% 470 $2K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 64 $2K
85018 <1% 738 $2K
87329 <1% 160 $2K
77014 <1% 32 $2K
85379 <1% 163 $2K
93971 <1% 84 $2K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 12 $2K
84146 <1% 68 $2K
83721 <1% 139 $2K
64483 <1% 13 $1K
64615 <1% 13 $1K
86664 <1% 64 $1K
0031A <1% 34 $1K
99310 Prolong nursin fac eval 15m <1% 82 $1K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 29 $1K
86663 <1% 64 $1K
96375 Therapeutic injection; each additional sequential IV push <1% 61 $1K
76937 <1% 192 $1K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 114 $1K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 26 $1K
93793 <1% 193 $1K
36415 Collection of venous blood by venipuncture <1% 14,336 $962.64
86225 <1% 56 $904.32
93922 <1% 38 $890.39
93325 <1% 113 $885.44
51705 <1% 14 $856.43
73030 <1% 72 $847.05
82150 <1% 136 $826.68
99222 Initial hospital care, per day, moderate complexity <1% 38 $821.38
73564 <1% 44 $792.87
0112A <1% 18 $720.00
0054A <1% 23 $710.00
0074A <1% 17 $680.00
72100 <1% 26 $671.21
86769 <1% 12 $670.85
87420 <1% 156 $656.43
87075 <1% 76 $644.98
99306 Prolong nursin fac eval 15m <1% 44 $636.21
92587 <1% 13 $581.49
84702 <1% 31 $579.93
86696 <1% 28 $573.70
0003A <1% 14 $560.00
20553 <1% 31 $559.68
83521 <1% 53 $549.24
31575 <1% 12 $490.40
87328 <1% 41 $448.04
92083 <1% 13 $447.92
84480 <1% 25 $419.30
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 163 $397.64
86308 <1% 51 $390.68
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 133 $383.56
86334 <1% 25 $375.89
96127 <1% 51 $370.52
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 12 $362.89
82627 <1% 12 $349.37
82977 <1% 38 $332.59
95251 <1% 13 $330.21
0296T <1% 24 $327.61
0298T <1% 36 $312.32
86200 <1% 38 $302.70
85045 <1% 107 $300.98
99429 <1% 12 $300.00
92579 <1% 13 $292.44
90670 <1% 15 $270.00
81015 <1% 88 $247.90
J7050 Infusion, normal saline solution, 250 cc <1% 70 $226.28
82950 <1% 38 $222.45
86695 <1% 13 $214.15
94060 <1% 12 $213.12
84132 <1% 156 $207.26
92133 <1% 12 $199.16
93298 <1% 12 $196.12
99307 <1% 72 $191.64
J1030 Injection, methylprednisolone acetate, 40 mg <1% 38 $190.78
77080 <1% 29 $186.77
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 16 $151.55
87493 <1% 12 $143.27
83655 <1% 30 $135.04
87324 <1% 12 $113.05
87206 <1% 14 $103.86
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 53 $96.35
97014 <1% 27 $69.53
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 45 $61.61
82330 <1% 28 $60.84
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) <1% 28 $36.12
90785 <1% 43 $3.88
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 13 $0.74
G0008 Administration of influenza virus vaccine 0% 797 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 0% 52 $0.00
G0009 Administration of pneumococcal vaccine 0% 50 $0.00
93307 0% 12 $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 officialLOPES, KRISTA (SH VP, QUALITY, SAFETY, PATIENT EDU)
Same official

Other billing entities under LOPES, KRISTA

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.