South County Orthopedic Specialists
South County Orthopedic Specialists was paid $232K by Medicaid between Jan 2018 and Nov 2024, across 15 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 34% of everything it billed.
33Billing provider infoSOUTH COUNTY ORTHOPEDIC SPECIALISTS
LAGUNA WOODS, CA 92637
LAGUNA WOODS, CA 92637
33aNPI1053314625assigned 05/27/2005
33bProvider typeSpecialist
28Total paid$232K
24GClaims8,128
24DCodes billed15
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in California
Rank by total paid#397 of 1,230
Median peer was paid$51K
This provider vs. median4.5×
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 | 1,990 | $3K | |
| 2019 | 780 | $3K | |
| 2020 | 1,331 | $4K | |
| 2021 | 1,432 | $86K | |
| 2022 | 1,244 | $63K | |
| 2023 | 1,002 | $55K | |
| 2024incomplete | 349 | $17K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 34% | 814 | 802 | $79K |
| 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 | 27% | 1,330 | 1,267 | $63K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 24% | 2,929 | 2,679 | $55K |
| 20610 | 8.1% | 316 | 277 | $19K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.6% | 589 | 586 | $8K |
| 73564 | 1.6% | 569 | 446 | $4K | |
| 20611 | <1% | 528 | 426 | $2K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 665 | 613 | $648.31 |
| 72100 | <1% | 12 | 12 | $472.56 | |
| 73610 | <1% | 16 | 13 | $470.68 | |
| 73030 | <1% | 41 | 36 | $421.33 | |
| 73502 | <1% | 13 | 12 | $253.28 |
3 more codes
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 officialGERSTEN, LARRY (OFFICER)