Physician
San Marcos Medical Group INC.
San Marcos Medical Group INC. was paid $5.60M by Medicaid between Jan 2018 and Nov 2024, across 137 billing codes. Its largest line is G9012, Other specified case management service not elsewhere classified — 18% of everything it billed.
33Billing provider infoSAN MARCOS MEDICAL GROUP INC.
FONTANA, CA 92336
FONTANA, CA 92336
33aNPI1639129372assigned 05/11/2006
33bProvider typeFamily Medicine Physician
28Total paid$5.60M
24GClaims410,624
24DCodes billed137
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in California
Rank by total paid#65 of 2,511
Median peer was paid$13K
This provider vs. median436×
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 | 19,866 | $658K | |
| 2019 | 78,821 | $655K | |
| 2020 | 50,677 | $243K | |
| 2021 | 45,090 | $830K | |
| 2022 | 55,531 | $817K | |
| 2023 | 85,328 | $1.11M | |
| 2024incomplete | 75,311 | $1.28M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G9012 | Other specified case management service not elsewhere classified | 18% | 44,004 | 26,175 | $985K |
| 59425 | 13% | 15,007 | 10,724 | $710K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 41,213 | 38,309 | $614K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 8.3% | 21,202 | 19,981 | $462K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 4.8% | 593 | 593 | $270K |
| Z1034 | 4.7% | 4,309 | 3,030 | $265K | |
| J3490 | Unclassified drugs | 4.2% | 3,451 | 3,233 | $238K |
| 97802 | 3.8% | 15,217 | 14,834 | $213K | |
| 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 | 3.4% | 17,306 | 16,547 | $189K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.0% | 1,621 | 1,584 | $169K |
| 59514 | 2.6% | 337 | 337 | $145K | |
| Z1032 | 2.4% | 850 | 850 | $135K |
125 more codes
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.2% | 3,278 | $122K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.9% | 2,890 | $109K |
| 99460 | 1.8% | 2,049 | $100K | |
| 99381 | 1.8% | 1,357 | $98K | |
| 92551 | 1.4% | 10,246 | $79K | |
| Z6500 | <1% | 448 | $56K | |
| 59430 | <1% | 990 | $49K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 17,350 | $45K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 534 | $42K |
| 99000 | <1% | 28,821 | $41K | |
| 76801 | <1% | 606 | $37K | |
| 81025 | <1% | 13,064 | $35K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 234 | $30K |
| 81002 | <1% | 16,924 | $26K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 4,468 | $24K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 4,831 | $22K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 269 | $21K |
| 99383 | <1% | 648 | $20K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 4,026 | $18K |
| 99384 | <1% | 603 | $16K | |
| 99462 | <1% | 603 | $15K | |
| Z6410 | <1% | 1,772 | $14K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 348 | $12K |
| 90680 | <1% | 1,334 | $11K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 461 | $11K |
| 97803 | <1% | 719 | $11K | |
| 93000 | <1% | 855 | $10K | |
| 90670 | <1% | 2,515 | $10K | |
| 90698 | <1% | 2,038 | $10K | |
| 99382 | <1% | 218 | $9K | |
| 90744 | <1% | 1,550 | $8K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 83 | $7K |
| G9920 | Screening performed and negative | <1% | 10,256 | $6K |
| 99451 | <1% | 2,221 | $5K | |
| 0500F | <1% | 273 | $5K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 355 | $5K |
| S0197 | Prenatal vitamins, 30-day supply | <1% | 3,006 | $5K |
| 90633 | <1% | 1,694 | $4K | |
| 3351F | <1% | 309 | $3K | |
| 88141 | <1% | 452 | $3K | |
| 85018 | <1% | 15,687 | $3K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 74 | $3K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 2,133 | $2K |
| 86580 | <1% | 1,206 | $2K | |
| Q3014 | Telehealth originating site facility fee | <1% | 1,677 | $2K |
| 90651 | <1% | 648 | $2K | |
| 82947 | <1% | 1,251 | $2K | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 2,973 | $2K |
| 83655 | <1% | 1,692 | $2K | |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 534 | $2K |
| Z6400 | <1% | 215 | $2K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 32 | $2K |
| 57454 | <1% | 26 | $1K | |
| 90734 | <1% | 1,127 | $1K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 664 | $1K |
| 90686 | <1% | 466 | $1K | |
| S9083 | Global fee urgent care centers | <1% | 24 | $1K |
| G9008 | Coordinated care fee, physician coordinated care oversight services | <1% | 5,146 | $1K |
| 90716 | <1% | 511 | $1K | |
| 90677 | <1% | 165 | $1K | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 93 | $1K |
| 90658 | <1% | 664 | $1K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 64 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,211 | $900.09 |
| 90710 | <1% | 638 | $747.00 | |
| 90715 | <1% | 596 | $728.82 | |
| Z6204 | <1% | 91 | $699.90 | |
| 99385 | <1% | 610 | $662.36 | |
| 99442 | <1% | 276 | $603.68 | |
| Z6304 | <1% | 78 | $599.97 | |
| Z6406 | <1% | 76 | $583.31 | |
| 90649 | <1% | 321 | $562.50 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 2,079 | $550.80 |
| 99221 | <1% | 15 | $518.70 | |
| Z6300 | <1% | 33 | $510.52 | |
| Z6200 | <1% | 33 | $510.52 | |
| 85014 | <1% | 296 | $482.53 | |
| Z6402 | <1% | 31 | $478.71 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 72 | $415.62 |
| H2000 | Comprehensive multidisciplinary evaluation | <1% | 25 | $403.41 |
| 90707 | <1% | 308 | $360.00 | |
| 90696 | <1% | 356 | $342.00 | |
| 99173 | <1% | 5,363 | $183.41 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 38 | $178.40 |
| 90713 | <1% | 87 | $144.00 | |
| 99386 | <1% | 265 | $130.88 | |
| 90700 | <1% | 439 | $117.00 | |
| 90688 | <1% | 44 | $99.00 | |
| 90620 | <1% | 314 | $54.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 16 | $54.00 |
| 92557 | <1% | 99 | $53.46 | |
| 90657 | <1% | 80 | $36.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 1,020 | $32.00 |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 794 | $30.12 |
| 99406 | <1% | 170 | $26.74 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 849 | $22.04 |
| 90647 | <1% | 317 | $4.50 | |
| 81000 | <1% | 24 | $4.08 | |
| 3079F | 0% | 4,700 | $0.00 | |
| 3044F | 0% | 915 | $0.00 | |
| 3075F | 0% | 3,188 | $0.00 | |
| 3080F | 0% | 1,740 | $0.00 | |
| 3074F | 0% | 9,047 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 2,708 | $0.00 |
| 3008F | 0% | 1,717 | $0.00 | |
| H0001 | Alcohol and/or drug assessment | 0% | 132 | $0.00 |
| 2001F | 0% | 6,852 | $0.00 | |
| 90723 | 0% | 90 | $0.00 | |
| 3052F | 0% | 38 | $0.00 | |
| 99441 | 0% | 221 | $0.00 | |
| 0501F | 0% | 15 | $0.00 | |
| 99402 | 0% | 21 | $0.00 | |
| 3051F | 0% | 320 | $0.00 | |
| 0502F | 0% | 487 | $0.00 | |
| 3077F | 0% | 3,454 | $0.00 | |
| 3078F | 0% | 9,200 | $0.00 | |
| 3046F | 0% | 477 | $0.00 | |
| H0050 | Alcohol and/or drug services, brief intervention, per 15 minutes | 0% | 44 | $0.00 |
| 3045F | 0% | 115 | $0.00 | |
| 99408 | 0% | 49 | $0.00 | |
| H1000 | Prenatal care, at-risk assessment | 0% | 20 | $0.00 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 50 | $0.00 |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 21 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 30 | $0.00 |
| 90461 | 0% | 29 | $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 officialBALBIR, NATT (MD/PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| San Marcos Medical Group INC. | San Bernardino, CA | $901K |
| San Marcos Medical Group INC. | San Bernardino, CA | $322K |
| San Marcos Medical Group INC. | Riverside, CA | $50K |
| San Marcos Medical Group INC | Fontana, CA | $8K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.