Clinic
Nicolas De LA Pena MD INC
Nicolas De LA Pena MD INC was paid $634K by Medicaid between Jan 2018 and Nov 2024, across 7 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 69% of everything it billed.
33Billing provider infoNICOLAS DE LA PENA MD INC
MERCED, CA 95340
MERCED, CA 95340
33aNPI1578831996assigned 12/13/2011
33bProvider typeHealth Service Clinic/Center
28Total paid$634K
24GClaims16,563
24DCodes billed7
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Health Service Clinic/Center providers in California
Rank by total paid#20 of 87
Median peer was paid$88K
This provider vs. median7.2×
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 | 2,029 | $58K | |
| 2019 | 2,225 | $59K | |
| 2020 | 2,269 | $65K | |
| 2021 | 2,234 | $84K | |
| 2022 | 2,880 | $128K | |
| 2023 | 2,837 | $132K | |
| 2024incomplete | 2,089 | $109K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 69% | 10,379 | 2,322 | $437K |
| 99254 | 19% | 756 | 749 | $118K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.6% | 3,734 | 3,190 | $48K |
| 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 | 2.0% | 476 | 466 | $13K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.1% | 551 | 537 | $7K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 642 | 617 | $6K |
| 99255 | <1% | 25 | 25 | $5K |
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 officialDELA PENA, NICOLAS (PRESIDENT)