Care1st Health Plan

Care1st Health Plan was paid $12.34M by Medicaid between Nov 2018 and Dec 2021, across 42 billing codes. Its largest line is G9008, Coordinated care fee, physician coordinated care oversight services — 90% of everything it billed.

33Billing provider infoCARE1ST HEALTH PLAN
MONTEREY PARK, CA 91755

33aNPI1649423856assigned 10/31/2008

33bProvider typeHealth Maintenance Organization

28Total paid$12.34M

24GClaims67,732

24DCodes billed42

24AFirst – last monthNov 2018 – Dec 2021

Compared with peers

Next to other Health Maintenance Organization providers in California

Rank by total paid#18 of 151

Median peer was paid$59K

This provider vs. median209×

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	237	$18K
2019	10,358	$1.64M
2020	23,157	$5.44M
2021	33,980	$5.23M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G9008	Coordinated care fee, physician coordinated care oversight services	90%	47,447	15,668	$11.13M
99442		3.6%	5,676	5,406	$439K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.8%	1,951	1,873	$217K
99441		<1%	1,312	1,269	$62K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	711	700	$59K
97802		<1%	1,886	1,819	$58K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	300	299	$45K
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%	188	188	$33K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	<1%	263	263	$33K
99058		<1%	170	169	$26K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	170	170	$26K
99443		<1%	215	206	$24K

30 more codes

99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	181	$17K
81003		<1%	1,739	$15K
90710		<1%	87	$14K
90649		<1%	83	$13K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	68	$13K
85018		<1%	812	$12K
92551		<1%	479	$12K
90670		<1%	321	$12K
90734		<1%	80	$11K
81025		<1%	835	$11K
90686		<1%	343	$10K
99173		<1%	725	$7K
90647		<1%	263	$7K
99381		<1%	44	$7K
90723		<1%	190	$5K
82948		<1%	386	$5K
90633		<1%	128	$5K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	<1%	166	$4K
90680		<1%	123	$3K
90700		<1%	89	$3K
90715		<1%	31	$1K
90658		<1%	25	$925.00
93000		<1%	40	$692.80
90696		<1%	12	$629.86
G8418	Bmi is documented below normal parameters and a follow-up plan is documented	<1%	58	$0.13
3078F		<1%	37	$0.12
3725F		<1%	33	$0.11
G8420	Bmi is documented within normal parameters and no follow-up plan is required	<1%	14	$0.05
G0270	Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes	<1%	27	$0.05
3074F		0%	24	$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 officialJONES, BROOKS (COMPLIANCE OFFICER)