Managed care
Prospect Health Plan, INC.
Prospect Health Plan, INC. was paid $109K by Medicaid between Jul 2023 and Nov 2024, across 1 billing code. Its largest line is G9008, Coordinated care fee, physician coordinated care oversight services — 100% of everything it billed.
33Billing provider infoPROSPECT HEALTH PLAN, INC.
LOS ANGELES, CA 90025
LOS ANGELES, CA 90025
33aNPI1235502360assigned 11/11/2015
33bProvider typeHealth Maintenance Organization
28Total paid$109K
24GClaims297
24DCodes billed1
24AFirst – last monthJul 2023 – Nov 2024
Compared with peers
Next to other Health Maintenance Organization providers in California
Rank by total paid#66 of 151
Median peer was paid$59K
This provider vs. median1.9×
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 | |
|---|---|---|---|
| 2023 | 172 | $35K | |
| 2024incomplete | 125 | $74K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G9008 | Coordinated care fee, physician coordinated care oversight services | 100% | 297 | 191 | $109K |
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 officialSHIN, ELLEN (SECRETARY)
Parent organizationPHP HOLDINGS, INC.
| Provider | Location | Paid |
|---|---|---|
| Prospect Caring Hand, INC. | Vernon, CT | $13K |
| Nix Physicians INC. | San Antonio, TX | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.