Managed care
Family Health Alliance
Family Health Alliance was paid $59K by Medicaid between Jan 2018 and Aug 2021, across 49 billing codes. Its largest line is 99285, emergency room visit (most serious) — 25% of everything it billed.
33Billing provider infoFAMILY HEALTH ALLIANCE
ENCINO, CA 91436
ENCINO, CA 91436
33aNPI1619190881assigned 04/10/2007
33bProvider typeHealth Maintenance Organization
28Total paid$59K
24GClaims11,014
24DCodes billed49
24AFirst – last monthJan 2018 – Aug 2021
Compared with peers
Next to other Health Maintenance Organization providers in California
Rank by total paid#76 of 151
Median peer was paid$59K
This provider vs. median1.0×
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 | 8,406 | $54K | |
| 2019 | 70 | $2K | |
| 2020 | 1,383 | $2K | |
| 2021 | 1,155 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 25% | 138 | 124 | $15K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 24% | 191 | 181 | $14K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 23% | 269 | 249 | $13K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 1,612 | 1,412 | $7K |
| 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 | 4.2% | 203 | 184 | $2K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 4.0% | 154 | 153 | $2K |
| 99199 | Unlisted special service, procedure or report | 3.0% | 42 | 37 | $2K |
| 71045 | Radiologic examination, chest; single view | 1.2% | 96 | 62 | $693.77 |
| 80053 | Comprehensive metabolic panel | <1% | 993 | 913 | $578.61 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 803 | 731 | $356.84 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 190 | 190 | $332.08 |
| 36415 | Collection of venous blood by venipuncture | <1% | 548 | 526 | $191.37 |
37 more codes
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,123 | $175.64 |
| 99406 | <1% | 625 | $134.03 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 458 | $90.23 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 639 | $34.55 |
| 81001 | <1% | 357 | $33.17 | |
| 80061 | Lipid panel | <1% | 714 | $25.54 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 19 | $21.19 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 15 | $18.00 |
| 85027 | <1% | 82 | $15.87 | |
| 86140 | <1% | 52 | $9.74 | |
| 85610 | <1% | 29 | $8.28 | |
| 87088 | <1% | 44 | $6.78 | |
| 87070 | <1% | 15 | $5.40 | |
| 81003 | <1% | 13 | $3.10 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 93 | $1.82 |
| 86592 | 0% | 59 | $0.00 | |
| 92551 | 0% | 96 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 17 | $0.00 |
| 85652 | 0% | 53 | $0.00 | |
| 85018 | 0% | 96 | $0.00 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 0% | 154 | $0.00 |
| 84480 | 0% | 100 | $0.00 | |
| 84436 | 0% | 105 | $0.00 | |
| 86060 | 0% | 16 | $0.00 | |
| 3008F | 0% | 67 | $0.00 | |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 13 | $0.00 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 83 | $0.00 |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 0% | 25 | $0.00 |
| 90686 | 0% | 22 | $0.00 | |
| 81000 | 0% | 26 | $0.00 | |
| 84550 | 0% | 93 | $0.00 | |
| 99173 | 0% | 149 | $0.00 | |
| 81002 | 0% | 123 | $0.00 | |
| 92552 | 0% | 82 | $0.00 | |
| 86431 | 0% | 43 | $0.00 | |
| 86038 | 0% | 48 | $0.00 | |
| 96160 | 0% | 27 | $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 officialLOPEZ, JORGE (GROUP PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Compass Counseling Services, LLC | Orlando, FL | $4.28M |
| Ydzm Business Group LLC | Miami, FL | $510K |
| Dco US LLC | Juncos, PR | $0.00 |
| Ideal Family Dentistry LLC | North Chesterfield, VA | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.