Providence Medical Foundation
Providence Medical Foundation was paid $16K by Medicaid between Nov 2018 and Mar 2024, across 22 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 44% of everything it billed.
MISSION VIEJO, CA 92691
Next to other Physical Medicine & Rehabilitation Physician 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 | |
|---|---|---|---|
| 2018 | 18 | $100.08 | |
| 2020 | 1,841 | $5K | |
| 2021 | 119 | $4K | |
| 2022 | 249 | $7K | |
| 2023 | 57 | $0.00 | |
| 2024incomplete | 68 | $0.00 |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 44% | 537 | 509 | $7K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 18% | 57 | 56 | $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 | 12% | 555 | 478 | $2K |
| 99220 | 8.0% | 32 | 30 | $1K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 4.0% | 180 | 61 | $634.76 |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 3.9% | 36 | 34 | $618.79 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 3.7% | 213 | 164 | $589.44 |
| 99223 | Prolong inpt eval add15 m | 1.5% | 64 | 50 | $247.94 |
| 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 | 1.5% | 48 | 47 | $243.82 |
| 90686 | 1.1% | 16 | 15 | $174.08 | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 188 | 72 | $125.82 |
| 93000 | <1% | 54 | 50 | $106.43 |
10 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 38 | $68.19 |
| 90662 | <1% | 22 | $16.48 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 35 | $12.68 |
| G0008 | Administration of influenza virus vaccine | <1% | 39 | $10.76 |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 76 | $7.21 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 53 | $5.99 |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 0% | 12 | $0.00 |
| 99239 | Hospital discharge day management, more than 30 minutes | 0% | 30 | $0.00 |
| 90961 | 0% | 53 | $0.00 | |
| 99222 | Initial hospital care, per day, moderate complexity | 0% | 14 | $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.