Prohealth Partners, a Medical Group, INC.
Prohealth Partners, a Medical Group, INC. was paid $299K by Medicaid between Jan 2018 and Nov 2024, across 24 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 90% of everything it billed.
LONG BEACH, CA 90804
Next to other Endocrinology, Diabetes & Metabolism 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 | 767 | $19K | |
| 2019 | 958 | $40K | |
| 2020 | 1,165 | $35K | |
| 2021 | 1,915 | $57K | |
| 2022 | 1,063 | $59K | |
| 2023 | 877 | $51K | |
| 2024incomplete | 632 | $38K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 90% | 5,338 | 5,317 | $269K |
| 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% | 329 | 329 | $19K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.0% | 371 | 363 | $9K |
| 95251 | <1% | 64 | 63 | $2K | |
| 1003F | <1% | 85 | 85 | $403.00 | |
| 90686 | <1% | 20 | 20 | $90.00 | |
| 3008F | 0% | 180 | 179 | $0.00 | |
| 3074F | 0% | 102 | 99 | $0.00 | |
| 1036F | 0% | 105 | 105 | $0.00 | |
| 1123F | 0% | 98 | 98 | $0.00 | |
| 1126F | 0% | 63 | 63 | $0.00 | |
| 94760 | 0% | 12 | 12 | $0.00 |
12 more codes
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 97 | $0.00 |
| 3079F | 0% | 31 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 16 | $0.00 |
| 3725F | 0% | 12 | $0.00 | |
| 3078F | 0% | 88 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 98 | $0.00 |
| 1158F | 0% | 98 | $0.00 | |
| G9920 | Screening performed and negative | 0% | 12 | $0.00 |
| 1160F | 0% | 98 | $0.00 | |
| 96159 | 0% | 15 | $0.00 | |
| 1033F | 0% | 13 | $0.00 | |
| 1091F | 0% | 32 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.