Southern California Permanente Medical Group
Southern California Permanente Medical Group was paid $77K by Medicaid between Jan 2019 and Nov 2024, across 21 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 30% of everything it billed.
FONTANA, CA 92336
Next to other Health Maintenance Organization providers in California
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 452 | $1K | |
| 2020 | 364 | $5K | |
| 2021 | 13 | $195.00 | |
| 2022 | 427 | $7K | |
| 2023 | 653 | $29K | |
| 2024incomplete | 737 | $34K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 30% | 491 | 488 | $23K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 24% | 522 | 518 | $18K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 9.0% | 636 | 636 | $7K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 7.5% | 71 | 71 | $6K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 4.4% | 42 | 42 | $3K |
| 90686 | 4.2% | 141 | 141 | $3K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.1% | 25 | 25 | $3K |
| 92551 | 3.9% | 148 | 148 | $3K | |
| 90674 | 3.7% | 91 | 91 | $3K | |
| 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 | 3.5% | 100 | 99 | $3K |
| 90656 | 1.9% | 57 | 57 | $1K | |
| 87088 | 1.6% | 86 | 86 | $1K |
9 more codes
| 99177 | <1% | 42 | $600.00 | |
| 86580 | <1% | 43 | $423.36 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 14 | $300.00 |
| 81003 | <1% | 44 | $180.00 | |
| 87081 | <1% | 13 | $143.00 | |
| 90661 | <1% | 14 | $38.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 12 | $23.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 26 | $0.00 |
| 99173 | 0% | 28 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.