Physician
Pulmonary Critical Care Associates INC.
Pulmonary Critical Care Associates INC. was paid $571K by Medicaid between Jan 2018 and Oct 2024, across 8 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 53% of everything it billed.
33Billing provider infoPULMONARY CRITICAL CARE ASSOCIATES INC.
SIMI VALLEY, CA 93065
SIMI VALLEY, CA 93065
33aNPI1023063492assigned 05/24/2006
33bProvider typePulmonary Disease Physician
28Total paid$571K
24GClaims11,789
24DCodes billed8
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in California
Rank by total paid#32 of 225
Median peer was paid$53K
This provider vs. median11×
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 | 917 | $13K | |
| 2019 | 1,227 | $49K | |
| 2020 | 1,367 | $67K | |
| 2021 | 1,802 | $93K | |
| 2022 | 1,698 | $82K | |
| 2023 | 3,052 | $198K | |
| 2024incomplete | 1,726 | $69K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 53% | 6,771 | 2,229 | $303K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 34% | 3,151 | 544 | $194K |
| 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 | 7.7% | 1,330 | 1,279 | $44K |
| 99223 | Prolong inpt eval add15 m | 2.3% | 114 | 109 | $13K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.3% | 315 | 279 | $13K |
| 99497 | <1% | 81 | 81 | $2K | |
| 99310 | Prolong nursin fac eval 15m | <1% | 15 | 14 | $2K |
| 90674 | <1% | 12 | 12 | $29.46 |
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 officialFLORA, GURDIP (OWNER PRESIDENT)