Clinic
Tuality Medical Group LLC
Tuality Medical Group LLC was paid $11.52M by Medicaid between Jan 2018 and Dec 2024, across 139 billing codes. Its largest line is 99284, emergency room visit (serious) — 22% of everything it billed.
33Billing provider infoTUALITY MEDICAL GROUP LLC
HILLSBORO, OR 97123
HILLSBORO, OR 97123
33aNPI1073929782assigned 07/02/2014
33bProvider typeHealth Service Clinic/Center
28Total paid$11.52M
24GClaims262,532
24DCodes billed139
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Health Service Clinic/Center providers in Oregon
Rank by total paid#1 of 25
Median peer was paid$90K
This provider vs. median128×
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 | 12,430 | $655K | |
| 2019 | 34,361 | $1.60M | |
| 2020 | 32,060 | $1.26M | |
| 2021 | 35,577 | $1.64M | |
| 2022 | 47,899 | $2.03M | |
| 2023 | 54,639 | $2.16M | |
| 2024incomplete | 45,566 | $2.17M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 22% | 30,414 | 28,099 | $2.59M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 34,924 | 31,538 | $1.86M |
| 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 | 16% | 25,398 | 22,753 | $1.81M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 13% | 28,883 | 26,723 | $1.48M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 9.3% | 10,119 | 8,953 | $1.07M |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.0% | 4,330 | 4,024 | $342K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2.8% | 5,405 | 4,930 | $327K |
| 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 | 2.3% | 2,316 | 2,148 | $263K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1.4% | 2,635 | 2,343 | $161K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.4% | 30,610 | 24,236 | $157K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 1.1% | 2,191 | 1,995 | $123K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1.0% | 4,991 | 4,640 | $118K |
127 more codes
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 5,026 | $113K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 2,553 | $97K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 2,150 | $91K |
| 93975 | <1% | 1,317 | $68K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 1,433 | $65K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 1,683 | $53K |
| 99205 | Prolong outpt/office vis | <1% | 361 | $52K |
| 71045 | Radiologic examination, chest; single view | <1% | 11,039 | $49K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 6,964 | $49K |
| 76830 | Ultrasound, transvaginal | <1% | 1,566 | $42K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 1,653 | $42K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 416 | $34K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 1,565 | $33K |
| 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% | 2,602 | $29K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 260 | $26K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 207 | $24K |
| 99223 | Prolong inpt eval add15 m | <1% | 258 | $23K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,949 | $22K |
| S0317 | Disease management program; per diem | <1% | 28 | $22K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,764 | $19K |
| 76642 | <1% | 432 | $17K | |
| 88312 | <1% | 424 | $17K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | <1% | 295 | $17K |
| 95886 | <1% | 232 | $16K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 192 | $10K |
| 88307 | <1% | 155 | $10K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 204 | $10K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 100 | $8K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 37 | $8K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 143 | $8K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 42 | $8K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 68 | $7K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 53 | $6K |
| 73630 | <1% | 964 | $6K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 51 | $6K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 246 | $5K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 359 | $5K |
| 73562 | <1% | 661 | $5K | |
| 88313 | <1% | 324 | $5K | |
| 64721 | <1% | 18 | $4K | |
| 73610 | <1% | 640 | $4K | |
| 73030 | <1% | 584 | $4K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 47 | $4K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 142 | $4K |
| 73130 | <1% | 537 | $4K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 429 | $4K |
| 88342 | <1% | 122 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 193 | $3K |
| 72100 | <1% | 346 | $3K | |
| 90686 | <1% | 198 | $3K | |
| 88341 | <1% | 103 | $3K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 60 | $3K |
| 77066 | Tomosynthesis, mammo | <1% | 70 | $2K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 58 | $2K |
| 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% | 225 | $2K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 29 | $2K |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 50 | $2K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 33 | $2K |
| 71271 | <1% | 26 | $2K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 74 | $1K |
| 95251 | <1% | 67 | $1K | |
| 90674 | <1% | 54 | $1K | |
| 99358 | Prolong nursin fac eval 15m | <1% | 32 | $1K |
| 88304 | <1% | 127 | $1K | |
| 95816 | <1% | 32 | $1K | |
| 93971 | <1% | 71 | $982.43 | |
| 73222 | <1% | 12 | $921.63 | |
| 73110 | <1% | 126 | $868.97 | |
| 96127 | <1% | 268 | $867.32 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 47 | $816.13 |
| 77080 | <1% | 156 | $787.88 | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | <1% | 12 | $756.59 |
| 70551 | Magnetic resonance imaging, brain; without contrast material | <1% | 16 | $699.18 |
| 94060 | <1% | 78 | $598.47 | |
| 71250 | <1% | 14 | $551.37 | |
| 81003 | <1% | 328 | $531.95 | |
| 81002 | <1% | 259 | $531.08 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 29 | $419.77 |
| 73502 | <1% | 57 | $416.46 | |
| 93016 | <1% | 27 | $360.93 | |
| 51798 | <1% | 41 | $312.67 | |
| 73140 | <1% | 52 | $311.58 | |
| 76536 | <1% | 12 | $258.14 | |
| 99201 | <1% | 13 | $253.80 | |
| 93018 | <1% | 27 | $233.82 | |
| 94726 | <1% | 28 | $203.07 | |
| 72110 | <1% | 12 | $192.79 | |
| 73100 | <1% | 36 | $190.72 | |
| 94729 | <1% | 30 | $167.46 | |
| 99442 | <1% | 39 | $146.19 | |
| 99443 | <1% | 47 | $145.92 | |
| 73564 | <1% | 13 | $100.64 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 436 | $99.67 |
| 72040 | <1% | 12 | $99.51 | |
| 74018 | <1% | 17 | $96.42 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 874 | $71.19 |
| 77062 | <1% | 29 | $41.65 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 2,185 | $36.16 |
| 80053 | Comprehensive metabolic panel | <1% | 1,458 | $32.90 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 368 | $31.62 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 212 | $15.33 |
| 87634 | <1% | 174 | $12.48 | |
| 94010 | <1% | 12 | $10.98 | |
| 84484 | <1% | 465 | $10.14 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 12 | $9.60 |
| 83735 | <1% | 366 | $9.52 | |
| 83690 | <1% | 308 | $4.87 | |
| 85027 | <1% | 716 | $2.28 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 306 | $1.43 |
| 85610 | <1% | 158 | $0.69 | |
| 81001 | <1% | 247 | $0.55 | |
| 86850 | <1% | 218 | $0.52 | |
| 86901 | <1% | 330 | $0.49 | |
| 86900 | <1% | 330 | $0.48 | |
| 82728 | 0% | 231 | $0.00 | |
| 3074F | 0% | 2,596 | $0.00 | |
| 3079F | 0% | 274 | $0.00 | |
| 85652 | 0% | 24 | $0.00 | |
| 99000 | 0% | 14 | $0.00 | |
| 83605 | 0% | 107 | $0.00 | |
| 87040 | 0% | 29 | $0.00 | |
| 86140 | 0% | 25 | $0.00 | |
| 3078F | 0% | 1,725 | $0.00 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 0% | 10,007 | $0.00 |
| 80061 | Lipid panel | 0% | 70 | $0.00 |
| 87186 | 0% | 46 | $0.00 | |
| 1159F | 0% | 13 | $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 officialJAMES-NIELSEN, LORI (PRESIDENT & CEO)
Parent organizationTUALITY HEALTHCARE
| Provider | Location | Paid |
|---|---|---|
| Tuality Healthcare | Hillsboro, OR | $27.82M |
| Tuality Healthcare | Hillsboro, OR | $105K |
| Tuality Healthcare | Hillsboro, OR | $40K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.