Physician
Valley Heart Associates Medical Group INC
Valley Heart Associates Medical Group INC was paid $4.16M by Medicaid between Jan 2018 and Nov 2024, across 41 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 33% of everything it billed.
33Billing provider infoVALLEY HEART ASSOCIATES MEDICAL GROUP INC
MODESTO, CA 95350
MODESTO, CA 95350
33aNPI1689614562assigned 06/07/2006
33bProvider typeCardiovascular Disease Physician
28Total paid$4.16M
24GClaims116,281
24DCodes billed41
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Cardiovascular Disease Physician providers in California
Rank by total paid#18 of 714
Median peer was paid$28K
This provider vs. median147×
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 | 17,953 | $651K | |
| 2019 | 17,646 | $613K | |
| 2020 | 15,073 | $512K | |
| 2021 | 14,152 | $490K | |
| 2022 | 14,719 | $550K | |
| 2023 | 19,505 | $688K | |
| 2024incomplete | 17,233 | $654K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 33% | 39,817 | 38,481 | $1.36M |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 32% | 27,414 | 27,288 | $1.35M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 7.8% | 10,746 | 3,202 | $323K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 5.2% | 4,646 | 4,619 | $215K |
| 99223 | Prolong inpt eval add15 m | 2.7% | 1,664 | 1,650 | $114K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.6% | 3,088 | 1,311 | $108K |
| 93016 | 2.6% | 5,372 | 5,335 | $107K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 2.6% | 2,141 | 2,047 | $106K |
| 93018 | 2.3% | 5,157 | 5,119 | $95K | |
| 93880 | 1.5% | 2,220 | 2,217 | $61K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.5% | 875 | 872 | $61K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.3% | 4,711 | 4,389 | $54K |
29 more codes
| 93297 | 1.1% | 3,527 | $47K | |
| 99205 | Prolong outpt/office vis | <1% | 490 | $41K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 373 | $33K |
| 93295 | <1% | 1,088 | $32K | |
| 93294 | <1% | 798 | $14K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 506 | $10K |
| 93000 | <1% | 267 | $6K | |
| 99245 | <1% | 49 | $5K | |
| 99152 | <1% | 197 | $4K | |
| 93280 | <1% | 191 | $4K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 51 | $3K |
| 93458 | <1% | 12 | $3K | |
| 93296 | <1% | 179 | $3K | |
| 99255 | <1% | 25 | $2K | |
| 93227 | <1% | 67 | $1K | |
| 99153 | Mod sedat endo service >5yrs | <1% | 101 | $1K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 165 | $1K |
| 93244 | <1% | 45 | $693.00 | |
| 94618 | <1% | 25 | $340.60 | |
| 93290 | <1% | 14 | $124.66 | |
| G9920 | Screening performed and negative | 0% | 21 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 13 | $0.00 |
| 99173 | 0% | 18 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 14 | $0.00 |
| 99401 | 0% | 19 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 62 | $0.00 |
| 92551 | 0% | 22 | $0.00 | |
| 96156 | 0% | 66 | $0.00 | |
| 97802 | 0% | 25 | $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 officialMERILLAT, JOHN (PRESIDENT)