Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SUTTER BAY MEDICAL FOUNDATION

NPI: 1366898538 · ORINDA, CA 94563 · Clinical Medical Laboratory · NPI assigned 05/06/2016

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LOPES, KRISTA controls 20+ related entities in our dataset. Read more

$6.77M
Total Medicaid Paid
173,668
Total Claims
123,426
Beneficiaries
66
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLOPES, KRISTA (SH VP, QUALITY, SAFETY, PATIENT EDU)
NPI Enumeration Date05/06/2016

Related Entities

Other providers sharing the same authorized official: LOPES, KRISTA

ProviderCityStateTotal Paid
SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA $41.25M
SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA $19.65M
SUTTER BAY MEDICAL FOUNDATION SACRAMENTO CA $18.88M
SUTTER VALLEY MEDICAL FOUNDATION MODESTO CA $18.22M
SUTTER VALLEY MEDICAL FOUNDATION YUBA CITY CA $12.47M
SUTTER VALLEY MEDICAL FOUNDATION FAIRFIELD CA $3.92M
SUTTER VALLEY MEDICAL FOUNDATION SACRAMENTO CA $3.85M
SUTTER VALLEY MEDICAL FOUNDATION YUBA CITY CA $2.45M
SUTTER VALLEY MEDICAL FOUNDATION BROWNSVILLE CA $1.37M
SUTTER VALLEY MEDICAL FOUNDATION PLYMOUTH CA $407K
SUTTER VALLEY MEDICAL FOUNDATION MODESTO CA $303K
SUTTER VALLEY MEDICAL FOUNDATION YUBA CITY CA $272K
SUTTER VALLEY MEDICAL FOUNDATION YUBA CITY CA $93K
SUTTER BAY MEDICAL FOUNDATION SANTA CRUZ CA $77K
SUTTER MEDICAL FOUNDATION YUBA CITY CA $31K
SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA $29K
SUTTER BAY MEDICAL FOUNDATION MOUNTAIN VIEW CA $22K
SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA $11K
SUTTER BAY MEDICAL FOUNDATION LOS GATOS CA $10K
SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA $10K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 17,523 $419K
2019 20,783 $700K
2020 21,450 $798K
2021 27,142 $1.12M
2022 24,736 $1.06M
2023 33,119 $1.41M
2024 28,915 $1.26M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99233 Prolong inpt eval add15 m 70,225 33,236 $2.52M
99223 Prolong inpt eval add15 m 13,459 13,257 $839K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 2,558 2,542 $786K
99239 Hospital discharge day management, more than 30 minutes 14,763 14,487 $637K
99232 Subsequent hospital care, per day, moderate complexity 17,421 9,214 $486K
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 4,274 4,158 $299K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 7,110 6,373 $261K
J0585 Injection, onabotulinumtoxina, 1 unit 258 167 $233K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 11,036 10,417 $152K
99255 855 825 $74K
59025 Fetal non-stress test 6,503 5,007 $69K
99254 903 864 $51K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 515 306 $50K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 8,443 8,228 $44K
99222 Initial hospital care, per day, moderate complexity 784 773 $40K
99497 1,163 706 $32K
99238 Hospital discharge day management, 30 minutes or less 895 882 $26K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,191 1,181 $23K
59514 78 76 $17K
95811 163 146 $16K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,402 2,357 $15K
99245 353 350 $13K
99460 206 205 $10K
95810 Polysomnography; sleep staging with 4 or more additional parameters 146 125 $10K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 810 808 $9K
99244 Office or other outpatient consultation, moderate to high complexity 1,466 1,464 $8K
51701 382 375 $7K
93296 386 385 $4K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 143 74 $4K
99215 Prolong outpt/office vis 614 514 $4K
0012A 101 101 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 84 83 $3K
91322 22 22 $3K
0011A 124 124 $3K
45380 Colonoscopy, flexible; with biopsy, single or multiple 254 249 $2K
90480 36 36 $1K
93018 124 123 $1K
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 834 813 $989.04
93000 301 300 $966.33
99231 Subsequent hospital care, per day, straightforward or low complexity 74 51 $963.90
99253 14 14 $874.56
93297 145 145 $822.31
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 69 69 $814.51
99462 29 25 $760.75
90686 78 77 $757.17
11721 96 96 $729.96
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 245 244 $687.12
99205 Prolong outpt/office vis 38 38 $576.07
43259 27 26 $558.30
20610 235 163 $531.98
93294 39 39 $415.81
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 12 12 $375.93
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 53 53 $373.91
81003 716 633 $339.67
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 15 15 $326.05
99356 17 13 $302.26
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 181 181 $208.50
71046 Radiologic examination, chest; 2 views 43 43 $141.05
99243 39 39 $107.10
J1040 Injection, methylprednisolone acetate, 80 mg 28 19 $78.15
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 16 12 $62.34
J1885 Injection, ketorolac tromethamine, per 15 mg 17 13 $0.00
95886 13 13 $0.00
64615 13 13 $0.00
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) 19 15 $0.00
93295 12 12 $0.00