Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › CA › Orange › NPI 1316280233
Physician

Children's Hospital of Orange County

Children's Hospital of Orange County was paid $4.74M by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 55% of everything it billed.

33Billing provider infoCHILDREN'S HOSPITAL OF ORANGE COUNTY
ORANGE, CA 92868
33aNPI1316280233assigned 03/28/2013
28Total paid$4.74M
24GClaims59,436
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pediatric Gastroenterology Physician providers in California

Rank by total paid#2 of 26
Median peer was paid$5K
This provider vs. median901×

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 KELLY, MARK controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$50K$100K2018201920202021202220232024
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
YearClaimsPaid
20189,472$866K
20198,818$798K
20207,817$667K
20218,218$711K
20227,932$694K
20237,856$546K
2024incomplete9,323$456K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 55% 34,607 33,348 $2.62M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 14% 10,769 3,567 $667K
99245 12% 4,896 4,879 $591K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 7.6% 1,313 1,309 $361K
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 4.8% 4,497 4,399 $226K
99255 1.6% 679 663 $75K
99244 Office or other outpatient consultation, moderate to high complexity 1.3% 545 542 $60K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 1.1% 953 408 $51K
99205 Prolong outpt/office vis <1% 577 574 $41K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 25 25 $12K
S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) <1% 111 110 $7K
99254 <1% 75 73 $7K
8 more codes
99367 <1% 129 $7K
99080 <1% 85 $5K
Z4306 <1% 37 $2K
99417 Prolong home eval add 15m <1% 56 $2K
99223 Prolong inpt eval add15 m <1% 12 $1K
Z4304 <1% 25 $1K
99213 Doctor's office visit, returning patient (routine) <1% 33 $1K
Z4303 <1% 12 $356.40

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 officialKELLY, MARK (DIRECTOR, CS BUSINESS DEVELOPMENT)
Parent organizationCHILDREN'S HOSPITAL OF ORANGE COUNTY
Same official

Other billing entities under KELLY, MARK

Full network →

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.