Managed care
Golden Empire Managed Care, a Medical Group, INC
Golden Empire Managed Care, a Medical Group, INC was paid $214K by Medicaid between Jan 2018 and Sep 2018, across 65 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 39% of everything it billed.
33Billing provider infoGOLDEN EMPIRE MANAGED CARE, A MEDICAL GROUP, INC
BAKERSFIELD, CA 93309
BAKERSFIELD, CA 93309
33aNPI1275657827assigned 03/19/2007
33bProvider typeHealth Maintenance Organization
28Total paid$214K
24GClaims15,469
24DCodes billed65
24AFirst – last monthJan 2018 – Sep 2018
Compared with peers
Next to other Health Maintenance Organization providers in California
Rank by total paid#53 of 151
Median peer was paid$59K
This provider vs. median3.6×
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 | 15,469 | $214K |
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 | 39% | 2,117 | 1,822 | $83K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 23% | 1,464 | 1,307 | $50K |
| 80053 | Comprehensive metabolic panel | 15% | 1,185 | 1,063 | $33K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 3.7% | 105 | 105 | $8K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 3.5% | 108 | 107 | $7K |
| 83036 | Hemoglobin; glycosylated (A1C) | 2.2% | 442 | 434 | $5K |
| 80048 | Basic metabolic panel (calcium, ionized) | 1.7% | 200 | 154 | $4K |
| 36415 | Collection of venous blood by venipuncture | 1.5% | 1,160 | 1,109 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.4% | 486 | 374 | $3K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 1.1% | 334 | 331 | $2K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 1.0% | 58 | 15 | $2K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,463 | 1,247 | $2K |
53 more codes
| 99490 | Ccm add 20min | <1% | 164 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 123 | $1K |
| 80061 | Lipid panel | <1% | 889 | $935.23 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 13 | $882.28 |
| 81001 | <1% | 248 | $747.30 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 110 | $664.86 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 99 | $637.95 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 106 | $567.97 |
| 2001F | <1% | 503 | $543.93 | |
| 86038 | <1% | 108 | $509.96 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 89 | $365.55 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 16 | $319.36 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 57 | $306.29 |
| 3008F | <1% | 634 | $302.16 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 220 | $242.35 |
| 2010F | <1% | 509 | $204.70 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 18 | $186.11 |
| 84439 | <1% | 117 | $184.59 | |
| 82607 | <1% | 114 | $164.80 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 76 | $144.91 |
| 99401 | <1% | 120 | $123.56 | |
| 81003 | <1% | 19 | $90.73 | |
| 86140 | <1% | 78 | $73.48 | |
| 82043 | <1% | 163 | $54.78 | |
| 80076 | <1% | 62 | $49.34 | |
| 84436 | <1% | 43 | $38.01 | |
| 1159F | <1% | 102 | $33.23 | |
| 83880 | <1% | 16 | $30.15 | |
| 85610 | <1% | 34 | $17.63 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 567 | $17.17 |
| 92551 | <1% | 17 | $12.97 | |
| 83735 | <1% | 107 | $12.04 | |
| 85730 | <1% | 15 | $7.16 | |
| 85651 | <1% | 15 | $3.37 | |
| 84484 | <1% | 35 | $0.70 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 49 | $0.00 |
| 1160F | 0% | 101 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 79 | $0.00 |
| 84550 | 0% | 12 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 13 | $0.00 |
| 81002 | 0% | 37 | $0.00 | |
| 3078F | 0% | 73 | $0.00 | |
| 3077F | 0% | 14 | $0.00 | |
| 84479 | 0% | 51 | $0.00 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 26 | $0.00 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 0% | 106 | $0.00 |
| 94760 | 0% | 45 | $0.00 | |
| 3074F | 0% | 34 | $0.00 | |
| 86592 | 0% | 12 | $0.00 | |
| 84153 | 0% | 12 | $0.00 | |
| 1126F | 0% | 25 | $0.00 | |
| 1125F | 0% | 37 | $0.00 | |
| 83690 | 0% | 15 | $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 officialRISTENPART, SUSAN (PROVIDER RELATIONS)