Physician
South Counties Pediatric Critical Care Medical Group
South Counties Pediatric Critical Care Medical Group was paid $4.52M by Medicaid between Jan 2018 and Oct 2024, across 12 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 41% of everything it billed.
33Billing provider infoSOUTH COUNTIES PEDIATRIC CRITICAL CARE MEDICAL GROUP
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
33aNPI1609853688assigned 12/29/2005
33bProvider typePediatric Pulmonology Physician
28Total paid$4.52M
24GClaims58,690
24DCodes billed12
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Pediatric Pulmonology Physician providers in California
Rank by total paid#3 of 18
Median peer was paid$19K
This provider vs. median236×
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 | 14,293 | $967K | |
| 2019 | 17,996 | $1.37M | |
| 2020 | 6,063 | $620K | |
| 2021 | 6,361 | $544K | |
| 2022 | 7,003 | $475K | |
| 2023 | 5,184 | $358K | |
| 2024incomplete | 1,790 | $184K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 41% | 9,906 | 4,245 | $1.84M |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 16% | 15,391 | 6,645 | $700K |
| 99292 | 14% | 4,728 | 2,447 | $628K | |
| 99223 | Prolong inpt eval add15 m | 12% | 6,487 | 6,301 | $541K |
| 99239 | Hospital discharge day management, more than 30 minutes | 8.4% | 8,382 | 8,123 | $377K |
| 99356 | 7.4% | 10,214 | 7,641 | $334K | |
| 99357 | <1% | 1,427 | 1,245 | $43K | |
| 99418 | Prolong nursin fac eval 15m | <1% | 2,048 | 1,349 | $41K |
| 99472 | Subsequent inpatient pediatric critical care, per day, 2-5 years | <1% | 32 | 13 | $5K |
| 99236 | Prolong inpt eval add15 m | <1% | 36 | 36 | $4K |
| 01922 | <1% | 15 | 15 | $2K | |
| 99354 | <1% | 24 | 24 | $641.56 |
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 officialREDA, ZACHARIA (PRESIDENT)