Clinica Prenatal San Jose, INC.

Clinica Prenatal San Jose, INC. was paid $2.99M by Medicaid between Jan 2018 and Dec 2024, across 36 billing codes. Its largest line is H1001, Prenatal care, at-risk enhanced service; antepartum management — 31% of everything it billed.

33Billing provider infoCLINICA PRENATAL SAN JOSE, INC.
SANTA ANA, CA 92707

33aNPI1508046251assigned 11/10/2007

33bProvider typeObstetrics Physician

28Total paid$2.99M

24GClaims27,042

24DCodes billed36

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Obstetrics Physician providers in California

Rank by total paid#6 of 52

Median peer was paid$64K

This provider vs. median47×

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	1,581	$110K
2019	1,114	$73K
2020	1,433	$102K
2021	1,752	$109K
2022	1,475	$100K
2023	6,422	$604K
2024incomplete	13,265	$1.90M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H1001	Prenatal care, at-risk enhanced service; antepartum management	31%	9,771	6,805	$942K
59409	Vaginal delivery only (with or without episiotomy and/or forceps)	16%	681	680	$468K
Z1034		12%	6,236	4,200	$358K
59514		11%	583	570	$340K
Z1032		5.6%	1,198	1,197	$168K
H1000	Prenatal care, at-risk assessment	5.5%	978	976	$165K
59430		4.4%	1,218	1,101	$132K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.9%	1,322	1,285	$58K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	1.8%	380	380	$54K
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	1.8%	830	814	$53K
76801		1.7%	622	568	$49K
58300		1.4%	314	163	$42K

24 more codes

99204	Doctor's office visit, new patient (more involved)	1.1%	308	$32K
76805	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation	<1%	215	$23K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	<1%	263	$18K
99203	Doctor's office visit, new patient (routine)	<1%	236	$17K
59425		<1%	222	$15K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	<1%	12	$13K
59025	Fetal non-stress test	<1%	314	$9K
99283	Emergency room visit (moderate)	<1%	160	$8K
Z1038		<1%	118	$6K
76813		<1%	37	$4K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	123	$4K
Z6400		<1%	104	$3K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	24	$3K
57454		<1%	15	$2K
81025		<1%	504	$1K
H1003	Prenatal care, at-risk enhanced service; education	<1%	39	$1K
99232	Hospital visit by a doctor, follow-up day	<1%	31	$1K
58301		<1%	16	$896.87
99221		<1%	20	$787.20
99238	Hospital discharge day management, 30 minutes or less	<1%	14	$582.82
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	<1%	12	$420.50
Z6404		<1%	41	$311.89
Z6202		<1%	41	$311.89
Z6302		<1%	40	$304.32

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 officialAKERMAN, ALLAN (OFFICE MANAGER)