Managed care
Cal Care Ipa
Cal Care Ipa was paid $253K by Medicaid between Jan 2018 and Aug 2021, across 112 billing codes. Its largest line is U0003, Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r — 50% of everything it billed.
33Billing provider infoCAL CARE IPA
SAN MARINO, CA 91108
SAN MARINO, CA 91108
33aNPI1316132178assigned 09/13/2007
33bProvider typeExclusive Provider Organization
28Total paid$253K
24GClaims52,522
24DCodes billed112
24AFirst – last monthJan 2018 – Aug 2021
Compared with peers
Next to other Exclusive Provider Organization providers in California
Rank by total paid#21 of 55
Median peer was paid$90K
This provider vs. median2.8×
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 | 31,048 | $37K | |
| 2019 | 2,012 | $33K | |
| 2020 | 8,494 | $104K | |
| 2021 | 10,968 | $79K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 50% | 1,491 | 1,125 | $126K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 17% | 12,403 | 10,784 | $44K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 4.9% | 203 | 181 | $12K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 4.8% | 1,227 | 198 | $12K |
| 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 | 3.7% | 2,145 | 1,996 | $9K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 2.3% | 1,050 | 995 | $6K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 2.0% | 123 | 95 | $5K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.7% | 81 | 79 | $4K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 1.7% | 1,036 | 982 | $4K |
| 80061 | Lipid panel | 1.3% | 2,469 | 2,463 | $3K |
| 80053 | Comprehensive metabolic panel | 1.2% | 2,871 | 2,813 | $3K |
| 84443 | Thyroid stimulating hormone (TSH) | 1.1% | 2,077 | 2,064 | $3K |
100 more codes
| 99199 | Unlisted special service, procedure or report | <1% | 193 | $2K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 2,832 | $2K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 95 | $2K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,047 | $2K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 1,293 | $2K |
| 99283 | Emergency room visit (moderate) | <1% | 127 | $1K |
| 59425 | <1% | 78 | $1K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 55 | $757.55 |
| 90686 | <1% | 147 | $734.94 | |
| 92081 | <1% | 589 | $723.20 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 891 | $705.50 |
| S9083 | Global fee urgent care centers | <1% | 82 | $675.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 250 | $660.15 |
| 97014 | <1% | 53 | $635.24 | |
| 92557 | <1% | 459 | $566.30 | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 483 | $520.96 |
| 92552 | <1% | 25 | $413.00 | |
| 97139 | <1% | 391 | $388.78 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 531 | $325.75 |
| 86592 | <1% | 555 | $205.84 | |
| 84439 | <1% | 664 | $195.13 | |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 500 | $175.00 |
| 85018 | <1% | 392 | $173.01 | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 55 | $150.74 |
| 90688 | <1% | 160 | $149.60 | |
| 83540 | <1% | 220 | $146.42 | |
| 81003 | <1% | 1,041 | $131.90 | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 53 | $81.87 |
| 82043 | <1% | 205 | $75.45 | |
| 99174 | <1% | 1,106 | $70.03 | |
| 81000 | <1% | 26 | $66.30 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,219 | $60.44 |
| 3008F | <1% | 494 | $54.00 | |
| 84550 | <1% | 261 | $45.00 | |
| 81001 | <1% | 228 | $38.15 | |
| 83550 | <1% | 159 | $34.17 | |
| 90685 | <1% | 27 | $25.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 238 | $12.36 |
| 83735 | <1% | 121 | $4.82 | |
| 85027 | <1% | 167 | $4.57 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 879 | $4.42 |
| 84481 | 0% | 49 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 214 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 172 | $0.00 |
| 85014 | 0% | 188 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 285 | $0.00 |
| 3725F | 0% | 105 | $0.00 | |
| 97803 | 0% | 52 | $0.00 | |
| 81002 | 0% | 226 | $0.00 | |
| 99401 | 0% | 291 | $0.00 | |
| 87186 | 0% | 38 | $0.00 | |
| 83655 | 0% | 68 | $0.00 | |
| 99173 | 0% | 167 | $0.00 | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 0% | 12 | $0.00 |
| 90649 | 0% | 12 | $0.00 | |
| 86038 | 0% | 111 | $0.00 | |
| 99072 | 0% | 136 | $0.00 | |
| 3078F | 0% | 106 | $0.00 | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 0% | 13 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 109 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 15 | $0.00 |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 0% | 43 | $0.00 |
| 82570 | 0% | 75 | $0.00 | |
| 83013 | 0% | 12 | $0.00 | |
| 3046F | 0% | 13 | $0.00 | |
| 97163 | 0% | 187 | $0.00 | |
| 3077F | 0% | 12 | $0.00 | |
| 71046 | Radiologic examination, chest; 2 views | 0% | 14 | $0.00 |
| 86431 | 0% | 30 | $0.00 | |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 0% | 72 | $0.00 |
| 96160 | 0% | 20 | $0.00 | |
| 90715 | 0% | 12 | $0.00 | |
| 86677 | 0% | 13 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 26 | $0.00 |
| 80074 | 0% | 14 | $0.00 | |
| 85610 | 0% | 13 | $0.00 | |
| 93000 | 0% | 63 | $0.00 | |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | 0% | 288 | $0.00 |
| 3074F | 0% | 179 | $0.00 | |
| 82150 | 0% | 98 | $0.00 | |
| 3072F | 0% | 62 | $0.00 | |
| 84479 | 0% | 76 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 12 | $0.00 |
| 84436 | 0% | 133 | $0.00 | |
| 86140 | 0% | 142 | $0.00 | |
| 92551 | 0% | 161 | $0.00 | |
| 85652 | 0% | 27 | $0.00 | |
| 1036F | 0% | 30 | $0.00 | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 0% | 48 | $0.00 |
| 99000 | 0% | 402 | $0.00 | |
| 93040 | 0% | 32 | $0.00 | |
| 99050 | 0% | 60 | $0.00 | |
| 82962 | 0% | 37 | $0.00 | |
| 87088 | 0% | 82 | $0.00 | |
| 84153 | 0% | 26 | $0.00 | |
| 88142 | 0% | 12 | $0.00 | |
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 0% | 21 | $0.00 |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 0% | 14 | $0.00 |
| 82607 | 0% | 13 | $0.00 | |
| 96156 | 0% | 12 | $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 officialPHAM, LAN (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Lan Ngoc Pham, DDS, INC | Westminster, CA | $1.52M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.