Clinic
James L. Kay, D.O., P.C.
James L. Kay, D.O., P.C. was paid $2.51M by Medicaid between Jan 2018 and Nov 2024, across 59 billing codes. Its largest line is 96156, — 25% of everything it billed.
33Billing provider infoJAMES L. KAY, D.O., P.C.
LAKE FOREST, CA 92630
LAKE FOREST, CA 92630
33aNPI1558646620assigned 10/20/2011
33bProvider typePrimary Care Clinic/Center
28Total paid$2.51M
24GClaims105,593
24DCodes billed59
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in California
Rank by total paid#35 of 422
Median peer was paid$25K
This provider vs. median102×
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 | 12,546 | $283K | |
| 2019 | 13,440 | $336K | |
| 2020 | 12,625 | $389K | |
| 2021 | 15,233 | $478K | |
| 2022 | 15,426 | $479K | |
| 2023 | 19,757 | $373K | |
| 2024incomplete | 16,566 | $174K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96156 | 25% | 9,711 | 9,632 | $618K | |
| 97803 | 11% | 13,559 | 13,462 | $274K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.3% | 3,815 | 3,746 | $207K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.0% | 8,474 | 8,029 | $202K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 6.5% | 2,884 | 2,871 | $164K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.4% | 3,389 | 3,378 | $160K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.7% | 3,421 | 3,401 | $142K |
| G9920 | Screening performed and negative | 4.2% | 5,736 | 5,719 | $106K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4.1% | 1,680 | 1,589 | $104K |
| 92551 | 3.7% | 9,073 | 9,029 | $94K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.1% | 4,971 | 4,851 | $77K |
| 96151 | 2.5% | 2,783 | 2,743 | $63K |
47 more codes
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 1.5% | 3,038 | $38K |
| 87110 | <1% | 1,688 | $23K | |
| 90658 | <1% | 1,883 | $17K | |
| 90670 | <1% | 1,906 | $16K | |
| 99406 | <1% | 1,428 | $15K | |
| 90698 | <1% | 1,599 | $13K | |
| 90680 | <1% | 1,370 | $11K | |
| 90633 | <1% | 1,443 | $11K | |
| 90651 | <1% | 1,272 | $10K | |
| 96127 | <1% | 2,820 | $10K | |
| 87070 | <1% | 1,688 | $10K | |
| 90710 | <1% | 1,189 | $9K | |
| 85018 | <1% | 4,826 | $9K | |
| 90744 | <1% | 1,106 | $9K | |
| 83655 | <1% | 1,053 | $8K | |
| 97802 | <1% | 344 | $8K | |
| 90734 | <1% | 1,069 | $8K | |
| 90686 | <1% | 1,400 | $7K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 284 | $7K |
| 90655 | <1% | 771 | $7K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 286 | $7K |
| 0002A | <1% | 164 | $7K | |
| 0001A | <1% | 133 | $5K | |
| 0071A | <1% | 91 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 38 | $4K |
| H0049 | Alcohol and/or drug screening | <1% | 145 | $3K |
| 0072A | <1% | 78 | $3K | |
| 90715 | <1% | 433 | $3K | |
| 99173 | <1% | 822 | $2K | |
| 90677 | <1% | 346 | $1K | |
| 96150 | <1% | 59 | $1K | |
| 90696 | <1% | 215 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 71 | $1K |
| 90700 | <1% | 175 | $1K | |
| 85999 | <1% | 367 | $1K | |
| 90649 | <1% | 82 | $954.99 | |
| 0074A | <1% | 22 | $880.00 | |
| 90648 | <1% | 115 | $866.71 | |
| 0004A | <1% | 21 | $840.00 | |
| 0154A | <1% | 21 | $840.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 74 | $791.80 |
| 0082A | <1% | 13 | $520.00 | |
| 99383 | <1% | 14 | $501.38 | |
| 88720 | <1% | 93 | $373.05 | |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 14 | $116.00 |
| 90716 | <1% | 13 | $36.00 | |
| G0136 | Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months | 0% | 15 | $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 officialKAY, JAMES (PEDIATRICIAN)