Clinic
Pacific Central Coast Health Centers
Pacific Central Coast Health Centers was paid $2.15M by Medicaid between Jan 2018 and Nov 2024, across 53 billing codes. Its largest line is H1001, Prenatal care, at-risk enhanced service; antepartum management — 26% of everything it billed.
33Billing provider infoPACIFIC CENTRAL COAST HEALTH CENTERS
SANTA MARIA, CA 93454
SANTA MARIA, CA 93454
33aNPI1275974461assigned 07/16/2013
33bProvider typeCommunity Health Clinic/Center
28Total paid$2.15M
24GClaims48,400
24DCodes billed53
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Community Health Clinic/Center providers in California
Rank by total paid#145 of 288
Median peer was paid$2.15M
This provider vs. median1.0×
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.
Entity ProliferationAuthorized official MERLO, BRANDON controls 20+ related entities in our dataset. Read more
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 | 4,548 | $213K | |
| 2019 | 3,479 | $155K | |
| 2020 | 5,365 | $240K | |
| 2021 | 9,216 | $440K | |
| 2022 | 8,856 | $429K | |
| 2023 | 9,215 | $387K | |
| 2024incomplete | 7,721 | $290K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | 26% | 8,804 | 6,440 | $554K |
| Z1034 | 12% | 4,614 | 3,413 | $255K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.9% | 1,645 | 1,543 | $192K |
| J3490 | Unclassified drugs | 8.4% | 1,076 | 956 | $182K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 5.1% | 1,163 | 1,069 | $111K |
| 59025 | Fetal non-stress test | 4.7% | 2,509 | 1,422 | $102K |
| H1003 | Prenatal care, at-risk enhanced service; education | 4.0% | 8,266 | 5,540 | $86K |
| H1000 | Prenatal care, at-risk assessment | 3.4% | 532 | 518 | $73K |
| 59430 | 2.8% | 231 | 210 | $60K | |
| H2000 | Comprehensive multidisciplinary evaluation | 2.6% | 382 | 373 | $56K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.6% | 662 | 614 | $56K |
| 97803 | 1.9% | 1,500 | 1,478 | $41K |
41 more codes
| 76830 | Ultrasound, transvaginal | 1.7% | 312 | $37K |
| 99401 | 1.7% | 1,816 | $36K | |
| 59425 | 1.7% | 476 | $36K | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | 1.4% | 3,228 | $30K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.2% | 217 | $25K |
| 90715 | 1.0% | 617 | $22K | |
| Z6410 | <1% | 2,575 | $20K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 99 | $17K |
| 96158 | <1% | 1,051 | $16K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 793 | $16K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 917 | $15K |
| 81025 | <1% | 1,456 | $13K | |
| Z6500 | <1% | 96 | $12K | |
| 90674 | <1% | 388 | $11K | |
| Z1032 | <1% | 64 | $10K | |
| Z6400 | <1% | 624 | $7K | |
| 90678 | <1% | 24 | $7K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 30 | $6K |
| S9452 | Nutrition classes, non-physician provider, per session | <1% | 332 | $6K |
| 96159 | <1% | 324 | $6K | |
| 96151 | <1% | 189 | $5K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 41 | $5K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 59 | $4K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 39 | $3K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 31 | $3K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 331 | $3K |
| 97802 | <1% | 104 | $2K | |
| 90686 | <1% | 92 | $2K | |
| Z6406 | <1% | 141 | $2K | |
| 96156 | <1% | 137 | $2K | |
| Z6204 | <1% | 130 | $2K | |
| Z6304 | <1% | 131 | $2K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 14 | $1K |
| 99221 | <1% | 12 | $954.47 | |
| Z1038 | <1% | 14 | $734.81 | |
| 90656 | <1% | 25 | $600.65 | |
| 96150 | <1% | 25 | $552.84 | |
| Z6208 | <1% | 12 | $181.68 | |
| Z6308 | <1% | 12 | $181.68 | |
| Z6414 | <1% | 12 | $174.11 | |
| 81002 | <1% | 26 | $85.23 |
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 officialMERLO, BRANDON (CHIEF FINANCIAL OFFICER)
Parent organizationPACIFIC CENTRAL COAST HEALTH CENTERS
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.