Managed care
Exceptional Care Medical Group, INC
Exceptional Care Medical Group, INC was paid $396K by Medicaid between Jan 2018 and Oct 2018, across 137 billing codes. Its largest line is 99283, emergency room visit (moderate) — 15% of everything it billed.
33Billing provider infoEXCEPTIONAL CARE MEDICAL GROUP, INC
ENCINO, CA 91436
ENCINO, CA 91436
33aNPI1083838163assigned 04/12/2007
33bProvider typeHealth Maintenance Organization
28Total paid$396K
24GClaims52,768
24DCodes billed137
24AFirst – last monthJan 2018 – Oct 2018
Compared with peers
Next to other Health Maintenance Organization providers in California
Rank by total paid#44 of 151
Median peer was paid$59K
This provider vs. median6.7×
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 | 52,768 | $396K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 15% | 1,261 | 1,188 | $61K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 14% | 511 | 468 | $56K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 12% | 696 | 668 | $48K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.1% | 8,872 | 7,726 | $20K |
| 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 | 5.1% | 586 | 567 | $20K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 4.1% | 395 | 112 | $16K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.1% | 347 | 346 | $12K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 3.1% | 262 | 260 | $12K |
| 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% | 214 | 214 | $12K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 2.8% | 566 | 555 | $11K |
| 59425 | 2.4% | 196 | 118 | $10K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.4% | 483 | 483 | $9K |
125 more codes
| 77067 | Screening mammography, bilateral, including computer-aided detection | 2.0% | 90 | $8K |
| 99223 | Prolong inpt eval add15 m | 1.9% | 47 | $8K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.7% | 155 | $7K |
| A0427 | Emergency ambulance ride, advanced life support | 1.7% | 46 | $7K |
| 99204 | Doctor's office visit, new patient (more involved) | 1.4% | 73 | $6K |
| J3490 | Unclassified drugs | 1.4% | 83 | $6K |
| 80053 | Comprehensive metabolic panel | 1.4% | 2,089 | $5K |
| 99243 | 1.1% | 64 | $4K | |
| 70450 | Computed tomography, head or brain; without contrast material | 1.1% | 128 | $4K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.1% | 3,372 | $4K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.0% | 271 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 3,230 | $4K |
| 71045 | Radiologic examination, chest; single view | <1% | 456 | $4K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 69 | $3K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 32 | $2K |
| A0429 | Emergency ambulance ride, basic life support | <1% | 16 | $2K |
| A4267 | Contraceptive supply, condom, male, each | <1% | 64 | $2K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 82 | $2K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 25 | $2K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 181 | $2K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 37 | $2K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 561 | $2K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 687 | $2K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 543 | $2K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 293 | $2K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 176 | $1K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 46 | $977.40 |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 33 | $856.15 |
| T4541 | Incontinence product, disposable underpad, large, each | <1% | 25 | $733.99 |
| 81001 | <1% | 1,042 | $716.87 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,272 | $676.46 |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 70 | $639.61 |
| 81025 | <1% | 177 | $545.68 | |
| 90649 | <1% | 84 | $540.00 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 15 | $477.14 |
| 81003 | <1% | 1,239 | $436.50 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 560 | $426.04 |
| 72100 | <1% | 26 | $377.18 | |
| 80076 | <1% | 350 | $350.45 | |
| 80061 | Lipid panel | <1% | 1,847 | $348.88 |
| 86703 | <1% | 265 | $313.65 | |
| 80305 | <1% | 25 | $250.92 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,065 | $247.42 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,561 | $239.24 |
| 3008F | <1% | 438 | $198.00 | |
| 86580 | <1% | 108 | $197.60 | |
| 85018 | <1% | 1,291 | $180.52 | |
| A0425 | Ground mileage, per statute mile | <1% | 209 | $178.61 |
| 86592 | <1% | 297 | $156.18 | |
| 87070 | <1% | 303 | $151.08 | |
| 73610 | <1% | 24 | $140.08 | |
| 73080 | <1% | 17 | $136.66 | |
| 86003 | <1% | 14 | $131.60 | |
| 90651 | <1% | 51 | $126.00 | |
| 85730 | <1% | 117 | $104.98 | |
| 73562 | <1% | 15 | $97.72 | |
| 90686 | <1% | 97 | $90.00 | |
| 90688 | <1% | 86 | $81.00 | |
| 74018 | <1% | 16 | $70.92 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 561 | $62.73 |
| 84480 | <1% | 343 | $62.73 | |
| 83655 | <1% | 517 | $49.27 | |
| 83690 | <1% | 119 | $47.44 | |
| 84703 | <1% | 110 | $45.43 | |
| 85610 | <1% | 207 | $44.14 | |
| 82274 | <1% | 81 | $41.60 | |
| 90620 | <1% | 13 | $36.00 | |
| 84439 | <1% | 674 | $31.21 | |
| 90734 | <1% | 13 | $27.00 | |
| 84484 | <1% | 47 | $26.93 | |
| 81002 | <1% | 763 | $25.88 | |
| 92552 | <1% | 395 | $25.16 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 82 | $24.24 |
| 36415 | Collection of venous blood by venipuncture | <1% | 159 | $24.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 17 | $20.48 |
| 99173 | <1% | 525 | $16.16 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 13 | $14.00 |
| 84702 | <1% | 49 | $13.24 | |
| 92081 | <1% | 466 | $9.00 | |
| 85651 | <1% | 162 | $8.69 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 20 | $7.27 |
| 84550 | <1% | 301 | $6.42 | |
| 86140 | <1% | 120 | $5.11 | |
| 82728 | <1% | 82 | $4.58 | |
| 84460 | <1% | 38 | $4.58 | |
| 87186 | <1% | 167 | $3.02 | |
| 87040 | <1% | 12 | $1.80 | |
| 82043 | 0% | 246 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 676 | $0.00 |
| 92551 | 0% | 835 | $0.00 | |
| 84153 | 0% | 191 | $0.00 | |
| 99000 | 0% | 723 | $0.00 | |
| 92060 | 0% | 309 | $0.00 | |
| 84479 | 0% | 244 | $0.00 | |
| 81000 | 0% | 326 | $0.00 | |
| 97802 | 0% | 73 | $0.00 | |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 359 | $0.00 |
| 83735 | 0% | 35 | $0.00 | |
| 3074F | 0% | 306 | $0.00 | |
| 86803 | 0% | 25 | $0.00 | |
| 84436 | 0% | 315 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 46 | $0.00 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 80 | $0.00 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 49 | $0.00 |
| 83550 | 0% | 50 | $0.00 | |
| 82951 | 0% | 15 | $0.00 | |
| 97035 | 0% | 37 | $0.00 | |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 29 | $0.00 |
| 1160F | 0% | 189 | $0.00 | |
| 1159F | 0% | 189 | $0.00 | |
| 92553 | 0% | 158 | $0.00 | |
| 90670 | 0% | 12 | $0.00 | |
| G0270 | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes | 0% | 28 | $0.00 |
| 84481 | 0% | 216 | $0.00 | |
| 3078F | 0% | 312 | $0.00 | |
| A0424 | Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) | 0% | 28 | $0.00 |
| 86038 | 0% | 26 | $0.00 | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 0% | 36 | $0.00 |
| 82947 | 0% | 95 | $0.00 | |
| 82570 | 0% | 257 | $0.00 | |
| 83540 | 0% | 52 | $0.00 | |
| 94664 | 0% | 33 | $0.00 | |
| 97803 | 0% | 28 | $0.00 | |
| 82948 | 0% | 15 | $0.00 | |
| 85014 | 0% | 25 | $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 officialOHIKHUARE, MAXWELL (GROUP PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| San Bernardino County Public Health Dept. | Hesperia, CA | $762K |
| San Bernardino County/Ccs | San Bernardino, CA | $460K |
| San Bernardino County Public Health Dept. | Montclair, CA | $436K |
| San Bernardino County Public Health Dept. | Redlands, CA | $221K |
| San Bernardino County Public Health Dept. | Fontana, CA | $164K |
| San Bernardino County Public Health Dept. | Colton, CA | $154K |
| San Bernardino County Public Health | Etiwanda, CA | $101K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.