Clinic
Pacific Central Coast Health Centers
Pacific Central Coast Health Centers was paid $2.02M by Medicaid between Jan 2018 and Nov 2024, across 30 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 40% of everything it billed.
33Billing provider infoPACIFIC CENTRAL COAST HEALTH CENTERS
SANTA MARIA, CA 93455
SANTA MARIA, CA 93455
33aNPI1306225941assigned 05/28/2015
33bProvider typeCommunity Health Clinic/Center
28Total paid$2.02M
24GClaims32,861
24DCodes billed30
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Community Health Clinic/Center providers in California
Rank by total paid#146 of 288
Median peer was paid$2.15M
This provider vs. median0.9×
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.
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 | 2,978 | $96K | |
| 2019 | 4,295 | $217K | |
| 2020 | 4,432 | $288K | |
| 2021 | 4,814 | $384K | |
| 2022 | 5,893 | $470K | |
| 2023 | 6,761 | $363K | |
| 2024incomplete | 3,688 | $200K |
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 | 40% | 8,348 | 8,062 | $812K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 9,350 | 8,977 | $636K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 11% | 1,990 | 1,968 | $229K |
| 99051 | 5.1% | 1,843 | 1,781 | $103K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.7% | 1,241 | 1,220 | $55K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 2.6% | 645 | 638 | $52K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.0% | 1,356 | 1,338 | $21K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 124 | 124 | $17K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 428 | 423 | $15K |
| 81025 | <1% | 1,346 | 1,324 | $14K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 870 | 861 | $13K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 688 | 656 | $11K |
18 more codes
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 246 | $10K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 208 | $9K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 48 | $9K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 47 | $4K |
| 81002 | <1% | 2,017 | $3K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 121 | $2K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,486 | $2K |
| 86308 | <1% | 95 | $458.86 | |
| 69209 | <1% | 15 | $215.05 | |
| 93000 | <1% | 12 | $140.96 | |
| 81003 | <1% | 55 | $135.50 | |
| 82962 | <1% | 41 | $128.21 | |
| 85018 | <1% | 12 | $24.85 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 12 | $24.08 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 13 | $16.96 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 109 | $12.66 |
| 3074F | <1% | 56 | $0.05 | |
| 3078F | <1% | 39 | $0.04 |
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.