Pain Management Specialists Medical Group
Pain Management Specialists Medical Group was paid $8.59M by Medicaid between Jan 2018 and Nov 2024, across 50 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 59% of everything it billed.
33Billing provider infoPAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
SAN LUIS OBISPO, CA 93405
SAN LUIS OBISPO, CA 93405
33aNPI1265435416assigned 05/23/2005
33bProvider typeSpecialist
28Total paid$8.59M
24GClaims353,496
24DCodes billed50
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in California
Rank by total paid#21 of 1,230
Median peer was paid$51K
This provider vs. median167×
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 | 43,921 | $941K | |
| 2019 | 50,225 | $1.04M | |
| 2020 | 61,299 | $1.13M | |
| 2021 | 78,064 | $1.76M | |
| 2022 | 52,464 | $1.90M | |
| 2023 | 45,676 | $1.00M | |
| 2024incomplete | 21,847 | $816K |
Box 24 · Service lines
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 | 59% | 77,202 | 71,199 | $5.05M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 18% | 40,901 | 39,493 | $1.53M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.3% | 35,009 | 31,826 | $457K |
| 62323 | 2.7% | 2,000 | 1,955 | $230K | |
| 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 | 2.1% | 1,601 | 1,601 | $184K |
| 01938 | 2.1% | 3,890 | 3,762 | $180K | |
| 01936 | 1.9% | 4,331 | 3,997 | $167K | |
| 01935 | 1.3% | 4,202 | 3,783 | $112K | |
| 64493 | 1.3% | 1,323 | 829 | $110K | |
| 99442 | <1% | 7,909 | 7,490 | $83K | |
| 27096 | <1% | 391 | 264 | $80K | |
| J7999 | Compounded drug, not otherwise classified | <1% | 741 | 629 | $71K |
38 more codes
| 64483 | <1% | 686 | $69K | |
| 62321 | <1% | 478 | $60K | |
| 64484 | <1% | 564 | $55K | |
| 01937 | <1% | 1,092 | $55K | |
| 99443 | <1% | 1,591 | $28K | |
| 76942 | <1% | 1,427 | $20K | |
| 01160 | <1% | 422 | $13K | |
| 62370 | <1% | 1,465 | $10K | |
| 99358 | Prolong nursin fac eval 15m | <1% | 239 | $9K |
| 20610 | <1% | 322 | $5K | |
| 98968 | <1% | 80 | $3K | |
| 01940 | <1% | 41 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 80 | $2K |
| 98967 | <1% | 298 | $2K | |
| 62367 | <1% | 695 | $2K | |
| 64494 | <1% | 16 | $830.97 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 180 | $801.40 |
| 95970 | <1% | 266 | $637.67 | |
| 99205 | Prolong outpt/office vis | <1% | 32 | $70.79 |
| 96146 | <1% | 39 | $42.97 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 54,836 | $15.65 |
| 62368 | <1% | 21 | $7.40 | |
| 1036F | <1% | 24,529 | $0.01 | |
| G9578 | Documentation of signed opioid treatment agreement at least once during opioid therapy | 0% | 7,548 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 9,489 | $0.00 |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 19,191 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 11,921 | $0.00 |
| G9584 | Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy | 0% | 9,331 | $0.00 |
| G9365 | One high-risk medication ordered | 0% | 200 | $0.00 |
| G9562 | Patients who had a follow-up evaluation conducted at least every three months during opioid therapy | 0% | 9,436 | $0.00 |
| 4004F | 0% | 246 | $0.00 | |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 0% | 2,056 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 6,441 | $0.00 |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 3,893 | $0.00 |
| 1006F | 0% | 732 | $0.00 | |
| G9583 | Patients prescribed opiates for longer than six weeks | 0% | 4,010 | $0.00 |
| 99058 | 0% | 89 | $0.00 | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 14 | $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 officialGRIBANOVA, INNA (MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Cypress Ambulatory Surgery Center | Santa Maria, CA | $3.90M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.