Lab
Sutter Bay Medical Foundation
Sutter Bay Medical Foundation was paid $6.77M by Medicaid between Jan 2018 and Dec 2024, across 66 billing codes. Its largest line is 99233, hospital visit by a doctor, follow-up day (complex) — 37% of everything it billed.
33Billing provider infoSUTTER BAY MEDICAL FOUNDATION
ORINDA, CA 94563
ORINDA, CA 94563
33aNPI1366898538assigned 05/06/2016
33bProvider typeClinical Medical Laboratory
28Total paid$6.77M
24GClaims173,668
24DCodes billed66
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in California
Rank by total paid#93 of 561
Median peer was paid$222K
This provider vs. median30×
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 LOPES, KRISTA 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 | 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 | |
| 2024incomplete | 28,915 | $1.26M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 37% | 70,225 | 33,236 | $2.52M |
| 99223 | Prolong inpt eval add15 m | 12% | 13,459 | 13,257 | $839K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 12% | 2,558 | 2,542 | $786K |
| 99239 | Hospital discharge day management, more than 30 minutes | 9.4% | 14,763 | 14,487 | $637K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 7.2% | 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 | 4.4% | 4,274 | 4,158 | $299K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 3.9% | 7,110 | 6,373 | $261K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 3.4% | 258 | 167 | $233K |
| 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 | 2.2% | 11,036 | 10,417 | $152K |
| 99255 | 1.1% | 855 | 825 | $74K | |
| 59025 | Fetal non-stress test | 1.0% | 6,503 | 5,007 | $69K |
| 99254 | <1% | 903 | 864 | $51K |
54 more codes
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 515 | $50K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 8,443 | $44K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 784 | $40K |
| 99497 | <1% | 1,163 | $32K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 895 | $26K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 1,191 | $23K |
| 59514 | <1% | 78 | $17K | |
| 95811 | <1% | 163 | $16K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 2,402 | $15K |
| 99245 | <1% | 353 | $13K | |
| 99460 | <1% | 206 | $10K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 146 | $10K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 810 | $9K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 1,466 | $8K |
| 51701 | <1% | 382 | $7K | |
| 93296 | <1% | 386 | $4K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 143 | $4K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 614 | $4K |
| 0012A | <1% | 101 | $3K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 84 | $3K |
| 91322 | <1% | 22 | $3K | |
| 0011A | <1% | 124 | $3K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 254 | $2K |
| 90480 | <1% | 36 | $1K | |
| 93018 | <1% | 124 | $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 | <1% | 834 | $989.04 |
| 93000 | <1% | 301 | $966.33 | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 74 | $963.90 |
| 99253 | <1% | 14 | $874.56 | |
| 93297 | <1% | 145 | $822.31 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 69 | $814.51 |
| 99462 | <1% | 29 | $760.75 | |
| 90686 | <1% | 78 | $757.17 | |
| 11721 | <1% | 96 | $729.96 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 245 | $687.12 |
| 99205 | Prolong outpt/office vis | <1% | 38 | $576.07 |
| 43259 | <1% | 27 | $558.30 | |
| 20610 | <1% | 235 | $531.98 | |
| 93294 | <1% | 39 | $415.81 | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 12 | $375.93 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 53 | $373.91 |
| 81003 | <1% | 716 | $339.67 | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 15 | $326.05 |
| 99356 | <1% | 17 | $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 | <1% | 181 | $208.50 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 43 | $141.05 |
| 99243 | <1% | 39 | $107.10 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 28 | $78.15 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 16 | $62.34 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 0% | 17 | $0.00 |
| 95886 | 0% | 13 | $0.00 | |
| 64615 | 0% | 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) | 0% | 19 | $0.00 |
| 93295 | 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 officialLOPES, KRISTA (SH VP, QUALITY, SAFETY, PATIENT EDU)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.