Clinic
Petaluma Health Center INC
Petaluma Health Center INC was paid $102.10M by Medicaid between Jan 2018 and Dec 2024, across 134 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 79% of everything it billed.
33Billing provider infoPETALUMA HEALTH CENTER INC
PETALUMA, CA 94954
PETALUMA, CA 94954
33aNPI1588656268assigned 08/18/2005
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$102.10M
24GClaims1,013,047
24DCodes billed134
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in California
Rank by total paid#22 of 826
Median peer was paid$4.05M
This provider vs. median25×
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 | 118,339 | $14.65M | |
| 2019 | 138,334 | $13.57M | |
| 2020 | 166,874 | $14.48M | |
| 2021 | 160,649 | $14.66M | |
| 2022 | 137,588 | $11.93M | |
| 2023 | 136,868 | $14.25M | |
| 2024incomplete | 154,395 | $18.55M |
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 | 79% | 386,921 | 315,697 | $80.82M |
| 00003 | Internal/system code - not a standard HCPCS code | 16% | 63,070 | 57,856 | $16.26M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.3% | 227,360 | 144,186 | $1.35M |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 20,359 | 8,215 | $530K |
| 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% | 68,850 | 41,512 | $454K |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | <1% | 5,548 | 4,254 | $381K |
| 97810 | <1% | 27,956 | 10,880 | $309K | |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 18,355 | 9,347 | $291K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 20,504 | 10,189 | $233K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 57,115 | 34,687 | $232K |
| 90686 | <1% | 11,469 | 9,343 | $137K | |
| 98940 | <1% | 9,058 | 3,770 | $136K |
122 more codes
| 0002A | <1% | 1,874 | $97K | |
| 59425 | <1% | 1,189 | $73K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 1,624 | $72K |
| 0001A | <1% | 1,304 | $68K | |
| 0004A | <1% | 1,202 | $59K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 3,762 | $48K |
| 97802 | <1% | 1,195 | $47K | |
| J3490 | Unclassified drugs | <1% | 540 | $45K |
| 0064A | <1% | 911 | $44K | |
| 97803 | <1% | 1,460 | $38K | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 2,814 | $34K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 3,905 | $31K |
| 99401 | <1% | 1,860 | $26K | |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 41 | $22K |
| 90656 | <1% | 1,703 | $18K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 625 | $12K |
| 90670 | <1% | 1,807 | $11K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 231 | $11K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | <1% | 12 | $11K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 2,816 | $9K |
| 0003A | <1% | 168 | $8K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 2,908 | $8K |
| 99283 | Emergency room visit (moderate) | <1% | 17,999 | $8K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 248 | $8K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 2,025 | $7K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 235 | $7K |
| H2000 | Comprehensive multidisciplinary evaluation | <1% | 430 | $7K |
| 99381 | <1% | 366 | $7K | |
| 59430 | <1% | 99 | $7K | |
| 57455 | <1% | 114 | $6K | |
| G9920 | Screening performed and negative | <1% | 198 | $6K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 513 | $5K |
| 58300 | <1% | 58 | $5K | |
| 96156 | <1% | 375 | $5K | |
| 90697 | <1% | 685 | $5K | |
| 11981 | <1% | 24 | $5K | |
| 90723 | <1% | 892 | $5K | |
| 87428 | <1% | 136 | $5K | |
| 90715 | <1% | 232 | $4K | |
| 90647 | <1% | 796 | $4K | |
| 81025 | <1% | 1,704 | $4K | |
| 90680 | <1% | 732 | $4K | |
| 0012A | <1% | 81 | $4K | |
| 90677 | <1% | 551 | $4K | |
| 90633 | <1% | 587 | $3K | |
| 99402 | <1% | 195 | $3K | |
| 90710 | <1% | 448 | $3K | |
| 90746 | <1% | 58 | $3K | |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 297 | $3K |
| 90681 | <1% | 343 | $2K | |
| 94010 | <1% | 228 | $2K | |
| 0011A | <1% | 42 | $2K | |
| H1000 | Prenatal care, at-risk assessment | <1% | 12 | $2K |
| 59025 | Fetal non-stress test | <1% | 372 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 150 | $2K |
| 90651 | <1% | 255 | $2K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 60 | $2K |
| 0013A | <1% | 25 | $1K | |
| 92015 | Determination of refractive state | <1% | 821 | $1K |
| 99460 | <1% | 21 | $1K | |
| 92133 | <1% | 46 | $1K | |
| 0124A | <1% | 14 | $938.00 | |
| 90632 | <1% | 15 | $822.99 | |
| 81002 | <1% | 2,909 | $689.91 | |
| 83655 | <1% | 75 | $648.43 | |
| G0467 | Community health center visit, returning patient | <1% | 5,510 | $619.50 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 49 | $587.34 |
| 90700 | <1% | 87 | $436.62 | |
| 11721 | <1% | 125 | $430.70 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 18 | $423.96 |
| 99462 | <1% | 29 | $388.08 | |
| 90734 | <1% | 67 | $387.00 | |
| S9452 | Nutrition classes, non-physician provider, per session | <1% | 32 | $269.12 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 76 | $205.80 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 37 | $185.21 |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 22 | $148.50 |
| 94150 | <1% | 64 | $147.18 | |
| 99406 | <1% | 26 | $145.74 | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 21 | $137.80 |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 12 | $133.50 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 599 | $120.97 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 159 | $120.42 |
| 90674 | <1% | 13 | $117.00 | |
| 90619 | <1% | 21 | $117.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 34 | $109.90 |
| 99383 | <1% | 22 | $109.66 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 86 | $109.33 |
| 90837 | Psychotherapy session, about an hour | <1% | 162 | $98.02 |
| 90620 | <1% | 18 | $90.00 | |
| T1014 | Telehealth transmission, per minute, professional services bill separately | <1% | 182 | $42.48 |
| 85018 | <1% | 221 | $23.96 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 40 | $16.40 |
| 81001 | <1% | 54 | $11.08 | |
| 86580 | <1% | 54 | $10.08 | |
| 81003 | <1% | 13 | $5.49 | |
| Z6300 | 0% | 562 | $0.00 | |
| Z6400 | 0% | 152 | $0.00 | |
| Z6200 | 0% | 564 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 96 | $0.00 |
| Z6414 | 0% | 237 | $0.00 | |
| Z6202 | 0% | 56 | $0.00 | |
| 90653 | 0% | 96 | $0.00 | |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit | 0% | 330 | $0.00 |
| 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 | 0% | 58 | $0.00 |
| 9212 | 0% | 126 | $0.00 | |
| Z6302 | 0% | 86 | $0.00 | |
| 91322 | 0% | 15 | $0.00 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 0% | 26 | $0.00 |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 0% | 21 | $0.00 |
| A4550 | Surgical trays | 0% | 19 | $0.00 |
| Z6406 | 0% | 1,586 | $0.00 | |
| Z1034 | 0% | 6,389 | $0.00 | |
| Z6402 | 0% | 547 | $0.00 | |
| Z6204 | 0% | 991 | $0.00 | |
| Z6410 | 0% | 3,399 | $0.00 | |
| Z1032 | 0% | 134 | $0.00 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 0% | 2,865 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 110 | $0.00 |
| 9213 | 0% | 661 | $0.00 | |
| 2000F | 0% | 15 | $0.00 | |
| Z1038 | 0% | 12 | $0.00 | |
| 9214 | 0% | 59 | $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 officialPOWELL, KATHRYN (CEO)