Managed care
Memorialcare Select Health Plan
Memorialcare Select Health Plan was paid $1.54M by Medicaid between Jan 2018 and Oct 2018, across 267 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 8.4% of everything it billed.
33Billing provider infoMEMORIALCARE SELECT HEALTH PLAN
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
33aNPI1407293814assigned 05/24/2013
33bProvider typeHealth Maintenance Organization
28Total paid$1.54M
24GClaims162,385
24DCodes billed267
24AFirst – last monthJan 2018 – Oct 2018
Compared with peers
Next to other Health Maintenance Organization providers in California
Rank by total paid#33 of 151
Median peer was paid$59K
This provider vs. median26×
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 | 162,385 | $1.54M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 8.4% | 4,011 | 3,831 | $130K |
| 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 | 6.5% | 1,154 | 1,128 | $101K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | 6.1% | 98 | 98 | $95K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.9% | 2,570 | 2,552 | $91K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.4% | 17,326 | 15,952 | $83K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 5.1% | 1,043 | 988 | $79K |
| 99223 | Prolong inpt eval add15 m | 4.9% | 410 | 367 | $76K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 4.5% | 1,459 | 1,430 | $69K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.9% | 629 | 620 | $61K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 3.3% | 1,551 | 719 | $51K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 2.9% | 1,290 | 1,246 | $44K |
| 59425 | 2.8% | 1,205 | 825 | $43K |
255 more codes
| 99232 | Hospital visit by a doctor, follow-up day | 2.6% | 1,252 | $40K |
| 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | 2.4% | 69 | $37K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.3% | 981 | $36K |
| 99203 | Doctor's office visit, new patient (routine) | 2.1% | 781 | $32K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 2.0% | 884 | $31K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.0% | 994 | $30K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | 1.6% | 638 | $25K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 1.5% | 2,955 | $24K |
| J3490 | Unclassified drugs | 1.5% | 205 | $24K |
| B4161 | Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 1.5% | 41 | $23K |
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 1.4% | 178 | $22K |
| 99205 | Prolong outpt/office vis | 1.1% | 159 | $17K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 125 | $15K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 255 | $15K |
| 92586 | <1% | 326 | $14K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 100 | $14K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 285 | $13K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 365 | $12K |
| A4267 | Contraceptive supply, condom, male, each | <1% | 142 | $12K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 133 | $12K |
| 76813 | <1% | 105 | $11K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 976 | $10K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 58 | $10K |
| 85018 | <1% | 3,292 | $9K | |
| 92557 | <1% | 93 | $9K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 197 | $9K |
| 59025 | Fetal non-stress test | <1% | 324 | $7K |
| E0570 | Nebulizer, with compressor | <1% | 120 | $6K |
| 71045 | Radiologic examination, chest; single view | <1% | 371 | $6K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 12 | $5K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 1,857 | $5K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 924 | $5K |
| 76830 | Ultrasound, transvaginal | <1% | 128 | $5K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 56 | $5K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 438 | $5K |
| 97803 | <1% | 131 | $4K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 82 | $4K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 148 | $4K |
| 59426 | <1% | 84 | $4K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 215 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 106 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 45 | $3K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 28 | $2K |
| 81025 | <1% | 948 | $2K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 6,533 | $2K |
| A0429 | Emergency ambulance ride, basic life support | <1% | 13 | $2K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 214 | $2K |
| 99053 | <1% | 70 | $2K | |
| 99460 | <1% | 44 | $2K | |
| 92551 | <1% | 2,297 | $2K | |
| 97162 | <1% | 18 | $2K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 1,779 | $1K |
| S9452 | Nutrition classes, non-physician provider, per session | <1% | 64 | $1K |
| 88307 | <1% | 15 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 94 | $1K |
| 99201 | <1% | 14 | $1K | |
| 92134 | <1% | 40 | $1K | |
| 90715 | <1% | 61 | $1K | |
| 80053 | Comprehensive metabolic panel | <1% | 7,033 | $1K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 36 | $1K |
| 92225 | <1% | 106 | $1K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 32 | $978.68 |
| 86592 | <1% | 2,119 | $931.57 | |
| 90696 | <1% | 227 | $912.20 | |
| A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | <1% | 104 | $892.89 |
| 99383 | <1% | 12 | $837.12 | |
| 86580 | <1% | 174 | $830.00 | |
| 90670 | <1% | 1,109 | $753.00 | |
| 88304 | <1% | 33 | $615.60 | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 1,831 | $551.34 |
| 82728 | <1% | 414 | $538.95 | |
| 81001 | <1% | 3,333 | $538.88 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 3,313 | $522.63 |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 12 | $496.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 645 | $474.45 |
| H2000 | Comprehensive multidisciplinary evaluation | <1% | 190 | $457.95 |
| 90633 | <1% | 826 | $396.00 | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 12 | $379.77 |
| 99000 | <1% | 810 | $341.13 | |
| 90686 | <1% | 84 | $309.52 | |
| A7015 | Aerosol mask, used with dme nebulizer | <1% | 117 | $290.87 |
| 80061 | Lipid panel | <1% | 3,324 | $257.25 |
| 92060 | <1% | 1,242 | $255.56 | |
| 90700 | <1% | 338 | $253.00 | |
| 99356 | <1% | 192 | $240.00 | |
| 90707 | <1% | 758 | $235.00 | |
| 90651 | <1% | 13 | $204.00 | |
| 90716 | <1% | 750 | $180.00 | |
| 81002 | <1% | 1,560 | $149.88 | |
| 86901 | <1% | 1,101 | $139.42 | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 313 | $134.12 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 2,946 | $124.48 |
| 87806 | <1% | 52 | $116.06 | |
| 3078F | <1% | 128 | $114.10 | |
| 90698 | <1% | 843 | $108.33 | |
| 87070 | <1% | 573 | $103.75 | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 25 | $96.43 |
| 87653 | <1% | 15 | $91.56 | |
| 82785 | <1% | 264 | $88.08 | |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | <1% | 839 | $81.06 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 3,567 | $79.48 |
| 83001 | <1% | 77 | $78.27 | |
| 73630 | <1% | 16 | $78.10 | |
| 85027 | <1% | 4,047 | $74.15 | |
| 90657 | <1% | 41 | $72.00 | |
| 90658 | <1% | 100 | $72.00 | |
| 90649 | <1% | 122 | $72.00 | |
| 86900 | <1% | 1,101 | $70.14 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 3,327 | $67.16 |
| 80074 | <1% | 649 | $67.12 | |
| 84702 | <1% | 407 | $66.20 | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 474 | $63.85 |
| 87210 | <1% | 111 | $60.28 | |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | <1% | 123 | $54.36 |
| 82947 | <1% | 271 | $52.40 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 2,438 | $47.97 |
| 82950 | <1% | 363 | $46.48 | |
| 87340 | <1% | 375 | $45.60 | |
| 90647 | <1% | 186 | $45.00 | |
| 99001 | <1% | 122 | $43.79 | |
| 83970 | <1% | 50 | $42.93 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 112 | $41.94 |
| 86003 | <1% | 313 | $27.90 | |
| 99173 | <1% | 1,117 | $27.82 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 78 | $27.06 |
| 90743 | <1% | 252 | $27.00 | |
| 90680 | <1% | 326 | $27.00 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 7,694 | $25.32 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 101 | $24.00 |
| 83498 | <1% | 232 | $20.34 | |
| 85610 | <1% | 1,239 | $18.12 | |
| 84100 | <1% | 380 | $16.78 | |
| 81003 | <1% | 827 | $15.50 | |
| 90744 | <1% | 171 | $9.00 | |
| 80076 | <1% | 890 | $8.94 | |
| 82043 | <1% | 492 | $5.08 | |
| 85730 | <1% | 941 | $3.86 | |
| 87147 | <1% | 256 | $1.92 | |
| 87081 | <1% | 515 | $1.14 | |
| 85007 | <1% | 878 | $0.54 | |
| 86850 | 0% | 792 | $0.00 | |
| 86880 | 0% | 42 | $0.00 | |
| 83550 | 0% | 355 | $0.00 | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 0% | 1,548 | $0.00 |
| 3074F | 0% | 160 | $0.00 | |
| 87040 | 0% | 286 | $0.00 | |
| 82746 | 0% | 194 | $0.00 | |
| 84484 | 0% | 130 | $0.00 | |
| 83735 | 0% | 520 | $0.00 | |
| 82550 | 0% | 31 | $0.00 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 1,036 | $0.00 |
| 84703 | 0% | 582 | $0.00 | |
| 97014 | 0% | 1,043 | $0.00 | |
| 83615 | 0% | 90 | $0.00 | |
| 83021 | 0% | 284 | $0.00 | |
| 85379 | 0% | 26 | $0.00 | |
| 92226 | 0% | 125 | $0.00 | |
| 94760 | 0% | 1,101 | $0.00 | |
| 86803 | 0% | 393 | $0.00 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 13 | $0.00 |
| 87088 | 0% | 1,341 | $0.00 | |
| 83880 | 0% | 168 | $0.00 | |
| 84153 | 0% | 156 | $0.00 | |
| 83690 | 0% | 689 | $0.00 | |
| 82261 | 0% | 210 | $0.00 | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | 0% | 64 | $0.00 |
| 82378 | 0% | 31 | $0.00 | |
| 90688 | 0% | 47 | $0.00 | |
| 86762 | 0% | 103 | $0.00 | |
| 80081 | 0% | 175 | $0.00 | |
| 85652 | 0% | 628 | $0.00 | |
| 96161 | 0% | 105 | $0.00 | |
| 88141 | 0% | 61 | $0.00 | |
| 86140 | 0% | 592 | $0.00 | |
| 83789 | 0% | 210 | $0.00 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 0% | 15 | $0.00 |
| 83605 | 0% | 183 | $0.00 | |
| 82607 | 0% | 251 | $0.00 | |
| 84436 | 0% | 52 | $0.00 | |
| 88142 | 0% | 67 | $0.00 | |
| 3008F | 0% | 198 | $0.00 | |
| 36416 | 0% | 102 | $0.00 | |
| 82962 | 0% | 97 | $0.00 | |
| 92567 | 0% | 186 | $0.00 | |
| 93000 | 0% | 28 | $0.00 | |
| 96127 | 0% | 55 | $0.00 | |
| 96151 | 0% | 143 | $0.00 | |
| 86780 | 0% | 13 | $0.00 | |
| 82784 | 0% | 13 | $0.00 | |
| 87077 | 0% | 546 | $0.00 | |
| 97750 | 0% | 30 | $0.00 | |
| 82951 | 0% | 29 | $0.00 | |
| 87390 | 0% | 14 | $0.00 | |
| 86376 | 0% | 13 | $0.00 | |
| 97018 | 0% | 30 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 71 | $0.00 |
| 83986 | 0% | 15 | $0.00 | |
| 87205 | 0% | 89 | $0.00 | |
| 83002 | 0% | 12 | $0.00 | |
| 82120 | 0% | 14 | $0.00 | |
| 80047 | 0% | 20 | $0.00 | |
| 86225 | 0% | 14 | $0.00 | |
| 82952 | 0% | 14 | $0.00 | |
| 86160 | 0% | 14 | $0.00 | |
| 84480 | 0% | 13 | $0.00 | |
| 86706 | 0% | 14 | $0.00 | |
| 20610 | 0% | 19 | $0.00 | |
| 81000 | 0% | 17 | $0.00 | |
| 82274 | 0% | 125 | $0.00 | |
| 82948 | 0% | 309 | $0.00 | |
| 94150 | 0% | 56 | $0.00 | |
| 83540 | 0% | 426 | $0.00 | |
| 82776 | 0% | 210 | $0.00 | |
| 0502F | 0% | 370 | $0.00 | |
| 83516 | 0% | 273 | $0.00 | |
| 86038 | 0% | 259 | $0.00 | |
| 83655 | 0% | 1,207 | $0.00 | |
| 85014 | 0% | 106 | $0.00 | |
| 82248 | 0% | 202 | $0.00 | |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 0% | 128 | $0.00 |
| 87186 | 0% | 562 | $0.00 | |
| 84481 | 0% | 140 | $0.00 | |
| 84439 | 0% | 815 | $0.00 | |
| 84156 | 0% | 105 | $0.00 | |
| 92015 | Determination of refractive state | 0% | 84 | $0.00 |
| 82570 | 0% | 659 | $0.00 | |
| 99051 | 0% | 326 | $0.00 | |
| 90713 | 0% | 128 | $0.00 | |
| 99199 | Unlisted special service, procedure or report | 0% | 106 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 40 | $0.00 |
| H1003 | Prenatal care, at-risk enhanced service; education | 0% | 193 | $0.00 |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 0% | 116 | $0.00 |
| 86431 | 0% | 116 | $0.00 | |
| 99401 | 0% | 145 | $0.00 | |
| 92081 | 0% | 109 | $0.00 | |
| 11721 | 0% | 17 | $0.00 | |
| 92588 | 0% | 90 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 140 | $0.00 |
| 84550 | 0% | 313 | $0.00 | |
| 92579 | 0% | 25 | $0.00 | |
| 96152 | 0% | 64 | $0.00 | |
| 83525 | 0% | 12 | $0.00 | |
| 90681 | 0% | 53 | $0.00 | |
| 92568 | 0% | 95 | $0.00 | |
| 92133 | 0% | 25 | $0.00 | |
| 84403 | 0% | 65 | $0.00 | |
| A0425 | Ground mileage, per statute mile | 0% | 39 | $0.00 |
| 86923 | 0% | 16 | $0.00 | |
| 92083 | 0% | 41 | $0.00 | |
| 84146 | 0% | 31 | $0.00 | |
| 99152 | 0% | 12 | $0.00 | |
| 99188 | 0% | 12 | $0.00 | |
| 86703 | 0% | 14 | $0.00 | |
| 87075 | 0% | 29 | $0.00 | |
| 88312 | 0% | 18 | $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 officialFERRER, MARIBEL (CEO)
Parent organizationMEMORIAL HEALTH SERVICES