Santa Maria Gastroenterology Medical Group INC.

Santa Maria Gastroenterology Medical Group INC. was paid $12.28M by Medicaid between Jan 2018 and Nov 2024, across 28 billing codes. Its largest line is 88305, Level IV - Surgical pathology, gross and microscopic examination — 26% of everything it billed.

33Billing provider infoSANTA MARIA GASTROENTEROLOGY MEDICAL GROUP INC.
SANTA MARIA, CA 93454

33aNPI1386971687assigned 11/06/2009

33bProvider typeGastroenterology Physician

28Total paid$12.28M

24GClaims89,517

24DCodes billed28

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Gastroenterology Physician providers in California

Rank by total paid#2 of 363

Median peer was paid$55K

This provider vs. median224×

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	8,086	$848K
2019	9,976	$1.16M
2020	10,354	$1.27M
2021	13,233	$1.82M
2022	15,213	$2.37M
2023	17,838	$2.46M
2024incomplete	14,817	$2.35M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
88305	Level IV - Surgical pathology, gross and microscopic examination	26%	17,496	16,995	$3.23M
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	21%	22,305	21,570	$2.62M
45380	Colonoscopy, flexible; with biopsy, single or multiple	9.5%	5,178	5,164	$1.17M
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	9.5%	6,274	6,258	$1.17M
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	7.5%	5,067	5,034	$915K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	6.1%	2,484	2,480	$750K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	6.1%	9,156	8,981	$743K
00811		4.1%	7,835	7,798	$500K
00731		3.4%	6,469	6,448	$419K
88312		2.9%	3,778	3,756	$361K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	1.6%	1,660	1,639	$202K
46221		<1%	221	166	$50K

16 more codes

45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s)	<1%	133	$44K
99215	Doctor's office visit, returning patient (complex)	<1%	116	$21K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	633	$13K
99223	Prolong inpt eval add15 m	<1%	97	$13K
99243		<1%	102	$13K
99244	Office or other outpatient consultation, moderate to high complexity	<1%	58	$11K
88313		<1%	134	$9K
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	78	$6K
91110		<1%	12	$6K
00812		<1%	56	$5K
76981		<1%	42	$4K
99205	Prolong outpt/office vis	<1%	15	$4K
99232	Hospital visit by a doctor, follow-up day	<1%	24	$1K
99152		<1%	26	$918.98
91200		<1%	12	$436.09
99490	Ccm add 20min	<1%	56	$192.78

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 officialJAHNKE, ERIC (PARTNER)