Clinic
Pioneers Memorial Healthcare District
Pioneers Memorial Healthcare District was paid $10.00M by Medicaid between Jan 2018 and Dec 2024, across 129 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 77% of everything it billed.
33Billing provider infoPIONEERS MEMORIAL HEALTHCARE DISTRICT
CALEXICO, CA 92231
CALEXICO, CA 92231
33aNPI1437122769assigned 02/08/2006
33bProvider typeRural Health Clinic/Center
28Total paid$10.00M
24GClaims211,533
24DCodes billed129
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in California
Rank by total paid#57 of 215
Median peer was paid$3.62M
This provider vs. median2.8×
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 | 40,989 | $2.62M | |
| 2019 | 45,113 | $2.25M | |
| 2020 | 31,927 | $1.34M | |
| 2021 | 25,405 | $1.07M | |
| 2022 | 24,126 | $934K | |
| 2023 | 29,345 | $1.10M | |
| 2024incomplete | 14,628 | $696K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 77% | 45,103 | 41,621 | $7.72M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.9% | 52,079 | 46,923 | $686K |
| 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 | 4.3% | 19,174 | 18,223 | $428K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 3.7% | 10,069 | 8,881 | $368K |
| 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 | 2.0% | 3,805 | 3,629 | $196K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.1% | 2,921 | 2,902 | $111K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,413 | 4,097 | $55K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,275 | 3,984 | $48K |
| 0259 | <1% | 4,377 | 4,249 | $42K | |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 1,752 | 1,622 | $39K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 327 | 315 | $36K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 859 | 857 | $25K |
117 more codes
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 532 | $25K |
| 90686 | <1% | 1,368 | $16K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,370 | $13K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 1,188 | $10K |
| 0250 | <1% | 1,250 | $10K | |
| 80053 | Comprehensive metabolic panel | <1% | 2,106 | $9K |
| 99221 | <1% | 574 | $9K | |
| 0636 | <1% | 951 | $8K | |
| 76641 | <1% | 882 | $8K | |
| 87581 | <1% | 536 | $8K | |
| 87486 | <1% | 536 | $8K | |
| 82948 | <1% | 6,320 | $7K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,732 | $7K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 2,385 | $7K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,592 | $7K |
| 99000 | <1% | 3,175 | $6K | |
| 0761 | <1% | 959 | $6K | |
| 81003 | <1% | 4,814 | $6K | |
| 0361 | <1% | 55 | $5K | |
| 80061 | Lipid panel | <1% | 675 | $5K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 703 | $5K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 549 | $4K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 1,308 | $4K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 397 | $4K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 714 | $4K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 266 | $4K |
| 87077 | <1% | 931 | $3K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 343 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 956 | $3K |
| J0561 | Injection, penicillin g benzathine, 100,000 units | <1% | 16 | $3K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 522 | $3K |
| 59425 | <1% | 59 | $2K | |
| J3490 | Unclassified drugs | <1% | 2,248 | $2K |
| 81025 | <1% | 1,123 | $2K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 81 | $2K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 49 | $2K |
| 87186 | <1% | 323 | $2K | |
| 87070 | <1% | 292 | $2K | |
| 0710 | <1% | 644 | $2K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 26 | $1K |
| 90670 | <1% | 12 | $1K | |
| 51798 | <1% | 142 | $1K | |
| 81001 | <1% | 1,051 | $1K | |
| 92552 | <1% | 121 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,107 | $980.81 |
| 99201 | <1% | 82 | $927.78 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 41 | $787.96 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 85 | $744.80 |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 69 | $699.58 |
| J0780 | Injection, prochlorperazine, up to 10 mg | <1% | 33 | $614.21 |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 12 | $564.41 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 376 | $520.53 |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 177 | $449.28 |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | <1% | 12 | $415.25 |
| A4217 | Sterile water/saline, 500 ml | <1% | 472 | $348.00 |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 141 | $337.72 |
| 20610 | <1% | 25 | $312.95 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 91 | $262.53 |
| Q3014 | Telehealth originating site facility fee | <1% | 13 | $229.40 |
| 99443 | <1% | 74 | $223.84 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 553 | $223.48 |
| 73610 | <1% | 14 | $218.92 | |
| 0271 | <1% | 27 | $209.17 | |
| 59025 | Fetal non-stress test | <1% | 1,182 | $209.10 |
| 73630 | <1% | 12 | $188.88 | |
| 86580 | <1% | 105 | $154.56 | |
| 73140 | <1% | 13 | $147.83 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 268 | $144.56 |
| S0020 | Injection, bupivicaine hydrochloride, 30 ml | <1% | 34 | $110.11 |
| 99173 | <1% | 80 | $90.91 | |
| A4649 | Surgical supply; miscellaneous | <1% | 645 | $72.54 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 24 | $67.61 |
| J2704 | Injection, propofol, 10 mg | <1% | 96 | $49.40 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 392 | $39.16 |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 313 | $37.85 |
| 99442 | <1% | 157 | $31.43 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 504 | $16.91 |
| 81015 | <1% | 97 | $11.65 | |
| 82570 | <1% | 15 | $11.04 | |
| 84550 | <1% | 12 | $10.43 | |
| 83690 | <1% | 14 | $7.11 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 514 | $5.24 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 284 | $2.58 |
| 36415 | Collection of venous blood by venipuncture | 0% | 1,480 | $0.00 |
| A9270 | Non-covered item or service | 0% | 286 | $0.00 |
| Z7610 | 0% | 1,995 | $0.00 | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 0% | 320 | $0.00 |
| J1170 | Injection, hydromorphone, up to 4 mg | 0% | 25 | $0.00 |
| 0370 | 0% | 132 | $0.00 | |
| 85730 | 0% | 27 | $0.00 | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 0% | 27 | $0.00 |
| 0270 | 0% | 312 | $0.00 | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 0% | 83 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 40 | $0.00 |
| X6218 | 0% | 176 | $0.00 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 0% | 271 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 206 | $0.00 |
| 93000 | 0% | 13 | $0.00 | |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 23 | $0.00 |
| Z1034 | 0% | 22 | $0.00 | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 0% | 12 | $0.00 |
| 0272 | 0% | 476 | $0.00 | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 0% | 138 | $0.00 |
| 85610 | 0% | 42 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 609 | $0.00 |
| 90461 | 0% | 234 | $0.00 | |
| 88312 | 0% | 28 | $0.00 | |
| 77066 | Tomosynthesis, mammo | 0% | 61 | $0.00 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 99 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 12 | $0.00 |
| 77062 | 0% | 33 | $0.00 | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 0% | 29 | $0.00 |
| J1756 | Injection, iron sucrose, 1 mg | 0% | 60 | $0.00 |
| 71046 | Radiologic examination, chest; 2 views | 0% | 13 | $0.00 |
| 0360 | 0% | 13 | $0.00 | |
| 0750 | 0% | 29 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 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 officialHECKATHORNE, DANIEL (ASSOCIATE ADMIN FINANCE & CFO)