Prohealth Partners, a Medical Group
Prohealth Partners, a Medical Group was paid $139K by Medicaid between Aug 2018 and Oct 2024, across 13 billing codes. Its largest line is 99233, hospital visit by a doctor, follow-up day (complex) — 25% of everything it billed.
LAKEWOOD, CA 90712
Next to other Internal Medicine Physician 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 | |
|---|---|---|---|
| 2018 | 13 | $1K | |
| 2019 | 90 | $3K | |
| 2020 | 89 | $3K | |
| 2021 | 274 | $10K | |
| 2022 | 485 | $22K | |
| 2023 | 1,187 | $73K | |
| 2024incomplete | 625 | $27K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 25% | 741 | 307 | $34K |
| 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 | 24% | 812 | 768 | $34K |
| 99223 | Prolong inpt eval add15 m | 17% | 281 | 276 | $23K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 13% | 207 | 204 | $18K |
| 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 | 6.2% | 82 | 82 | $9K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.6% | 54 | 52 | $5K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.4% | 117 | 117 | $5K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.0% | 217 | 114 | $4K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 2.0% | 14 | 14 | $3K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.7% | 182 | 166 | $2K |
| 99254 | <1% | 28 | 28 | $1K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 13 | 13 | $449.89 |
1 more codes
| 93000 | <1% | 15 | $430.50 |
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.