Agency
Primary Care Health Network LLC
Primary Care Health Network LLC was paid $1.76M by Medicaid between Jan 2018 and Nov 2024, across 244 billing codes. Its largest line is G0467, community health center visit, returning patient — 30% of everything it billed.
33Billing provider infoPRIMARY CARE HEALTH NETWORK LLC
SAN DIEGO, CA 92108
SAN DIEGO, CA 92108
33aNPI1598122871assigned 01/18/2016
33bProvider typeCase Management Agency
28Total paid$1.76M
24GClaims1,898,996
24DCodes billed244
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Case Management Agency providers in California
Rank by total paid#50 of 167
Median peer was paid$395K
This provider vs. median4.4×
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 | 18,740 | $223K | |
| 2019 | 23,597 | $397K | |
| 2020 | 461,902 | $370K | |
| 2021 | 660,094 | $229K | |
| 2022 | 636,268 | $292K | |
| 2023 | 78,156 | $187K | |
| 2024incomplete | 20,239 | $58K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 30% | 20,192 | 17,273 | $532K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29% | 468,373 | 423,578 | $502K |
| 59425 | 6.5% | 2,224 | 1,675 | $115K | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 3.9% | 5,447 | 4,652 | $69K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | 3.8% | 102 | 100 | $66K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.7% | 162,875 | 150,985 | $66K |
| 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 | 2.8% | 108,515 | 101,852 | $49K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 2.3% | 76 | 75 | $41K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.5% | 83,141 | 54,496 | $27K |
| J7298 | Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg | 1.3% | 25 | 25 | $22K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.2% | 548 | 541 | $20K |
| 88141 | <1% | 320 | 133 | $16K |
232 more codes
| 11981 | <1% | 79 | $15K | |
| 58300 | <1% | 99 | $15K | |
| 99401 | <1% | 18,392 | $14K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 783 | $14K |
| 93000 | <1% | 539 | $13K | |
| G9920 | Screening performed and negative | <1% | 14,340 | $13K |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 2,360 | $10K |
| 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 | <1% | 125 | $9K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 8,436 | $9K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 5,380 | $9K |
| J3490 | Unclassified drugs | <1% | 136 | $8K |
| 92250 | <1% | 3,211 | $7K | |
| 99460 | <1% | 150 | $7K | |
| 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 | <1% | 220 | $6K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,482 | $5K |
| 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% | 510 | $5K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 15,192 | $5K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 10,149 | $5K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 217 | $4K |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 93 | $4K |
| 59025 | Fetal non-stress test | <1% | 782 | $4K |
| 90686 | <1% | 38,536 | $3K | |
| 99000 | <1% | 53,592 | $3K | |
| 98940 | <1% | 14,653 | $3K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 166 | $3K |
| 81025 | <1% | 9,387 | $3K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 97 | $2K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 31,605 | $2K |
| 81002 | <1% | 18,984 | $2K | |
| 96156 | <1% | 22,705 | $2K | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 5,581 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 9,718 | $2K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 5,405 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 37,267 | $1K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 12,695 | $1K |
| 97803 | <1% | 12,527 | $1K | |
| 59430 | <1% | 495 | $1K | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 4,976 | $1K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 191 | $1K |
| 92586 | <1% | 16 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 4,503 | $1K |
| 90715 | <1% | 896 | $974.88 | |
| 99462 | <1% | 38 | $967.65 | |
| 80061 | Lipid panel | <1% | 302 | $886.40 |
| 90677 | <1% | 76 | $807.60 | |
| 92552 | <1% | 11,386 | $692.62 | |
| 90670 | <1% | 2,308 | $672.00 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,847 | $515.10 |
| 97026 | <1% | 2,621 | $507.40 | |
| 81003 | <1% | 475 | $430.68 | |
| 85018 | <1% | 44,333 | $393.42 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 468 | $379.08 |
| 97802 | <1% | 660 | $377.44 | |
| 80053 | Comprehensive metabolic panel | <1% | 237 | $347.62 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 827 | $344.48 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 7,846 | $333.55 |
| 80050 | General health panel | <1% | 42 | $276.88 |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 669 | $231.00 |
| 90662 | <1% | 180 | $198.04 | |
| 90698 | <1% | 624 | $183.00 | |
| 92551 | <1% | 31,585 | $177.86 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,408 | $176.91 |
| 83655 | <1% | 81 | $136.76 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 666 | $124.14 |
| 90672 | <1% | 1,642 | $117.00 | |
| 99070 | <1% | 4,579 | $100.37 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 89 | $83.12 |
| 86703 | <1% | 1,173 | $76.72 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 3,474 | $70.66 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 19,272 | $67.56 |
| 90785 | <1% | 1,097 | $53.76 | |
| 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% | 62 | $44.50 |
| 92015 | Determination of refractive state | <1% | 6,987 | $31.96 |
| S9452 | Nutrition classes, non-physician provider, per session | <1% | 7,381 | $25.23 |
| U0005 | 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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 56 | $25.00 |
| 88142 | <1% | 162 | $18.13 | |
| 82043 | <1% | 53 | $15.24 | |
| 82570 | <1% | 53 | $13.80 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 58,290 | $11.74 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 88 | $10.54 |
| 82947 | <1% | 4,628 | $6.54 | |
| 97810 | <1% | 5,603 | $5.73 | |
| 96127 | <1% | 4,427 | $4.76 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 8,196 | $3.90 |
| 99173 | <1% | 43,247 | $2.30 | |
| A4267 | Contraceptive supply, condom, male, each | <1% | 12 | $0.36 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 7,839 | $0.03 |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 6,517 | $0.00 |
| 3074F | 0% | 26,889 | $0.00 | |
| 3008F | 0% | 7,871 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 74,894 | $0.00 |
| 3079F | 0% | 5,089 | $0.00 | |
| 3075F | 0% | 1,875 | $0.00 | |
| 1126F | 0% | 300 | $0.00 | |
| 99441 | 0% | 2,065 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 675 | $0.00 |
| H2000 | Comprehensive multidisciplinary evaluation | 0% | 486 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 5,733 | $0.00 |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 1,336 | $0.00 |
| 90688 | 0% | 2,799 | $0.00 | |
| 36416 | 0% | 1,157 | $0.00 | |
| 90620 | 0% | 242 | $0.00 | |
| 1170F | 0% | 58 | $0.00 | |
| 86580 | 0% | 81 | $0.00 | |
| 94760 | 0% | 4,548 | $0.00 | |
| 97814 | 0% | 1,135 | $0.00 | |
| 90651 | 0% | 2,041 | $0.00 | |
| G9008 | Coordinated care fee, physician coordinated care oversight services | 0% | 396 | $0.00 |
| 1000F | 0% | 80 | $0.00 | |
| 1125F | 0% | 616 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 0% | 1,190 | $0.00 |
| 90716 | 0% | 75 | $0.00 | |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | 0% | 4,599 | $0.00 |
| 3044F | 0% | 57 | $0.00 | |
| 3080F | 0% | 254 | $0.00 | |
| 87650 | 0% | 207 | $0.00 | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | 0% | 375 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 185 | $0.00 |
| 90723 | 0% | 13 | $0.00 | |
| 88720 | 0% | 175 | $0.00 | |
| G0443 | Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes | 0% | 99 | $0.00 |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 418 | $0.00 |
| 90696 | 0% | 215 | $0.00 | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 0% | 550 | $0.00 |
| 0500F | 0% | 14 | $0.00 | |
| 99402 | 0% | 14 | $0.00 | |
| 2023F | 0% | 53 | $0.00 | |
| T1019 | Help at home with bathing, dressing and eating, billed per 15 minutes | 0% | 38 | $0.00 |
| 81005 | 0% | 242 | $0.00 | |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 32 | $0.00 |
| 90697 | 0% | 227 | $0.00 | |
| 91301 | 0% | 132 | $0.00 | |
| 99443 | 0% | 162 | $0.00 | |
| 87428 | 0% | 205 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 85 | $0.00 |
| 0011A | 0% | 147 | $0.00 | |
| 90619 | 0% | 216 | $0.00 | |
| G9012 | Other specified case management service not elsewhere classified | 0% | 163 | $0.00 |
| 0134A | 0% | 15 | $0.00 | |
| 90744 | 0% | 123 | $0.00 | |
| 90674 | 0% | 103 | $0.00 | |
| 0012A | 0% | 45 | $0.00 | |
| 96151 | 0% | 53 | $0.00 | |
| 90739 | 0% | 62 | $0.00 | |
| 90647 | 0% | 13 | $0.00 | |
| 1220F | 0% | 33 | $0.00 | |
| G9664 | Patients who are currently statin therapy users or received an order (prescription) for statin therapy | 0% | 43 | $0.00 |
| 90680 | 0% | 49 | $0.00 | |
| 87430 | 0% | 15 | $0.00 | |
| 0503F | 0% | 25 | $0.00 | |
| 0001A | 0% | 122 | $0.00 | |
| S0315 | Disease management program; initial assessment and initiation of the program | 0% | 13 | $0.00 |
| 4010F | 0% | 15 | $0.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 0% | 15 | $0.00 |
| G0123 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision | 0% | 13 | $0.00 |
| 99381 | 0% | 12 | $0.00 | |
| 71045 | Radiologic examination, chest; single view | 0% | 12 | $0.00 |
| 72080 | 0% | 15 | $0.00 | |
| 90660 | 0% | 13 | $0.00 | |
| 82962 | 0% | 30 | $0.00 | |
| 57454 | 0% | 12 | $0.00 | |
| 72040 | 0% | 18 | $0.00 | |
| 1123F | 0% | 20 | $0.00 | |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 0% | 12 | $0.00 |
| 1159F | 0% | 126,421 | $0.00 | |
| 97813 | 0% | 2,418 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 20,977 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 1,524 | $0.00 |
| 3078F | 0% | 25,576 | $0.00 | |
| 96160 | 0% | 29,458 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 429 | $0.00 |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 0% | 451 | $0.00 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 0% | 64 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 743 | $0.00 |
| 99188 | 0% | 87 | $0.00 | |
| 90461 | 0% | 4,216 | $0.00 | |
| 90649 | 0% | 198 | $0.00 | |
| 11721 | 0% | 790 | $0.00 | |
| 90734 | 0% | 1,041 | $0.00 | |
| 85014 | 0% | 937 | $0.00 | |
| 90750 | 0% | 1,044 | $0.00 | |
| 82948 | 0% | 41 | $0.00 | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 0% | 1,344 | $0.00 |
| 99442 | 0% | 3,142 | $0.00 | |
| 97811 | 0% | 1,439 | $0.00 | |
| 99177 | 0% | 716 | $0.00 | |
| 90648 | 0% | 350 | $0.00 | |
| H1002 | Prenatal care, at risk enhanced service; care coordination | 0% | 175 | $0.00 |
| 0502F | 0% | 2,139 | $0.00 | |
| H1000 | Prenatal care, at-risk assessment | 0% | 216 | $0.00 |
| 92081 | 0% | 156 | $0.00 | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | 0% | 809 | $0.00 |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 228 | $0.00 |
| 4145F | 0% | 263 | $0.00 | |
| 3077F | 0% | 1,445 | $0.00 | |
| 90837 | Psychotherapy session, about an hour | 0% | 627 | $0.00 |
| 90710 | 0% | 646 | $0.00 | |
| 11056 | 0% | 12 | $0.00 | |
| 98942 | 0% | 759 | $0.00 | |
| 90633 | 0% | 737 | $0.00 | |
| S0316 | Disease management program, follow-up/reassessment | 0% | 264 | $0.00 |
| 1160F | 0% | 888 | $0.00 | |
| 98960 | 0% | 74 | $0.00 | |
| 90707 | 0% | 121 | $0.00 | |
| 3046F | 0% | 27 | $0.00 | |
| 90621 | 0% | 24 | $0.00 | |
| 1158F | 0% | 79 | $0.00 | |
| A4550 | Surgical trays | 0% | 27 | $0.00 |
| 90687 | 0% | 139 | $0.00 | |
| 90685 | 0% | 64 | $0.00 | |
| 11719 | 0% | 13 | $0.00 | |
| 90746 | 0% | 155 | $0.00 | |
| 11720 | 0% | 12 | $0.00 | |
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | 0% | 41 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 12 | $0.00 |
| 3016F | 0% | 36 | $0.00 | |
| 73130 | 0% | 12 | $0.00 | |
| 90611 | 0% | 16 | $0.00 | |
| 90681 | 0% | 13 | $0.00 | |
| 91300 | 0% | 93 | $0.00 | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 0% | 28 | $0.00 |
| 99201 | 0% | 379 | $0.00 | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 0% | 44 | $0.00 |
| 73562 | 0% | 14 | $0.00 | |
| 11750 | 0% | 26 | $0.00 | |
| 90846 | Family psychotherapy without the patient present, 50 minutes | 0% | 76 | $0.00 |
| 59426 | 0% | 75 | $0.00 | |
| 0002A | 0% | 12 | $0.00 | |
| 3725F | 0% | 36 | $0.00 | |
| 90700 | 0% | 25 | $0.00 | |
| M1016 | Female patients unable to bear children | 0% | 14 | $0.00 |
| 90714 | 0% | 16 | $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 officialTUTTLE, HENRY (CEO)
Parent organizationCOUNCIL OF COMMUNITY CLINICS