Clinic
Petaluma Health Center INC
Petaluma Health Center INC was paid $73.85M by Medicaid between Jan 2018 and Dec 2024, across 95 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 66% of everything it billed.
33Billing provider infoPETALUMA HEALTH CENTER INC
ROHNERT PARK, CA 94928
ROHNERT PARK, CA 94928
33aNPI1669870739assigned 12/05/2014
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$73.85M
24GClaims681,950
24DCodes billed95
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in California
Rank by total paid#42 of 826
Median peer was paid$4.05M
This provider vs. median18×
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 | 76,781 | $10.50M | |
| 2019 | 90,412 | $10.30M | |
| 2020 | 87,948 | $7.62M | |
| 2021 | 101,138 | $10.09M | |
| 2022 | 98,719 | $9.86M | |
| 2023 | 103,844 | $11.82M | |
| 2024incomplete | 123,108 | $13.66M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 66% | 236,058 | 191,317 | $49.07M |
| 00003 | Internal/system code - not a standard HCPCS code | 29% | 81,963 | 74,120 | $21.75M |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 24,735 | 9,651 | $715K |
| 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% | 135,147 | 83,800 | $482K |
| 97810 | <1% | 21,922 | 8,442 | $260K | |
| 98940 | <1% | 8,687 | 3,077 | $204K | |
| 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% | 54,903 | 33,053 | $192K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 12,305 | 5,966 | $166K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 15,215 | 7,282 | $138K |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | <1% | 1,748 | 1,322 | $107K |
| 0002A | <1% | 1,872 | 1,866 | $93K | |
| 90686 | <1% | 7,409 | 5,843 | $86K |
83 more codes
| 0001A | <1% | 1,353 | $68K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 1,526 | $62K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 27,161 | $61K |
| 59425 | <1% | 727 | $44K | |
| 0071A | <1% | 909 | $41K | |
| 0004A | <1% | 732 | $34K | |
| 0072A | <1% | 683 | $30K | |
| 0003A | <1% | 520 | $26K | |
| 90837 | Psychotherapy session, about an hour | <1% | 2,758 | $24K |
| 97803 | <1% | 728 | $18K | |
| G9920 | Screening performed and negative | <1% | 556 | $16K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,964 | $15K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 4,430 | $12K |
| 90656 | <1% | 1,101 | $12K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 607 | $11K |
| 97802 | <1% | 240 | $9K | |
| 98926 | <1% | 210 | $8K | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 677 | $8K |
| 99401 | <1% | 745 | $8K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 310 | $8K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 227 | $6K |
| 87428 | <1% | 162 | $5K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 2,560 | $5K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 2,324 | $5K |
| 90670 | <1% | 634 | $5K | |
| 99283 | Emergency room visit (moderate) | <1% | 6,882 | $4K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 251 | $3K |
| 92015 | Determination of refractive state | <1% | 3,235 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 1,230 | $2K |
| 90633 | <1% | 342 | $2K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 23 | $2K |
| 83655 | <1% | 194 | $2K | |
| 90723 | <1% | 251 | $2K | |
| 90647 | <1% | 253 | $2K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 116 | $2K |
| H2000 | Comprehensive multidisciplinary evaluation | <1% | 114 | $2K |
| 90710 | <1% | 176 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 83 | $1K |
| 81025 | <1% | 516 | $1K | |
| 99402 | <1% | 62 | $1K | |
| 96156 | <1% | 61 | $1K | |
| 90715 | <1% | 63 | $1K | |
| 0111A | <1% | 14 | $938.00 | |
| 90651 | <1% | 120 | $936.27 | |
| 90680 | <1% | 123 | $873.00 | |
| 90697 | <1% | 101 | $738.00 | |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 24 | $696.00 |
| 90677 | <1% | 127 | $675.00 | |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 48 | $454.14 |
| 90734 | <1% | 38 | $324.00 | |
| 99381 | <1% | 14 | $271.98 | |
| 81002 | <1% | 1,622 | $252.61 | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 144 | $199.12 |
| 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% | 67 | $159.02 |
| 90619 | <1% | 28 | $126.00 | |
| 90700 | <1% | 13 | $108.00 | |
| G0467 | Community health center visit, returning patient | <1% | 2,385 | $101.24 |
| 11721 | <1% | 38 | $86.14 | |
| 81003 | <1% | 83 | $80.36 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 149 | $66.90 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 246 | $36.10 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 76 | $20.97 |
| T1014 | Telehealth transmission, per minute, professional services bill separately | <1% | 129 | $17.04 |
| 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 | 0% | 193 | $0.00 |
| Z6200 | 0% | 143 | $0.00 | |
| 9212 | 0% | 21 | $0.00 | |
| Z6400 | 0% | 38 | $0.00 | |
| Z6414 | 0% | 13 | $0.00 | |
| Z6202 | 0% | 55 | $0.00 | |
| Z6300 | 0% | 96 | $0.00 | |
| 90653 | 0% | 28 | $0.00 | |
| A4550 | Surgical trays | 0% | 26 | $0.00 |
| 91322 | 0% | 18 | $0.00 | |
| Z6410 | 0% | 717 | $0.00 | |
| Z6204 | 0% | 746 | $0.00 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 0% | 1,228 | $0.00 |
| Z1034 | 0% | 2,125 | $0.00 | |
| Z6406 | 0% | 810 | $0.00 | |
| 9213 | 0% | 277 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 12 | $0.00 |
| Z6402 | 0% | 97 | $0.00 | |
| 85018 | 0% | 32 | $0.00 | |
| 9214 | 0% | 26 | $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 officialTOLEDO, PEDRO (INTERIM CEO)