Mid-Valley Pulmonary Medical Group, INC.

Mid-Valley Pulmonary Medical Group, INC. was paid $6.07M by Medicaid between Jan 2018 and Nov 2024, across 26 billing codes. Its largest line is 99308, Subsequent nursing facility care, per day, straightforward — 42% of everything it billed.

33Billing provider infoMID-VALLEY PULMONARY MEDICAL GROUP, INC.
SHERMAN OAKS, CA 91403

33aNPI1689688335assigned 07/28/2006

33bProvider typePulmonary Disease Physician

28Total paid$6.07M

24GClaims227,313

24DCodes billed26

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Pulmonary Disease Physician providers in California

Rank by total paid#2 of 225

Median peer was paid$53K

This provider vs. median114×

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	39,521	$653K
2019	40,129	$952K
2020	33,150	$998K
2021	32,412	$1.06M
2022	29,181	$929K
2023	27,146	$863K
2024incomplete	25,774	$622K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99308	Subsequent nursing facility care, per day, straightforward	42%	117,325	16,757	$2.58M
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	23%	55,758	12,726	$1.37M
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	18%	12,395	3,143	$1.07M
99223	Prolong inpt eval add15 m	8.6%	7,835	7,490	$522K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	2.7%	1,923	1,885	$164K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	1.8%	4,308	1,736	$108K
99205	Prolong outpt/office vis	1.2%	655	655	$72K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	<1%	8,869	8,630	$49K
94060		<1%	937	936	$30K
94729		<1%	950	949	$22K
94726		<1%	952	951	$21K
99307		<1%	3,381	1,440	$21K

14 more codes

99309	Subsequent nursing facility care, per day, low to moderate complexity	<1%	1,392	$19K
99214	Doctor's office visit, returning patient (more involved)	<1%	533	$13K
99255		<1%	159	$12K
94618		<1%	333	$6K
1036F		<1%	2,864	$0.02
G9903	Patient screened for tobacco use and identified as a tobacco non-user	<1%	2,909	$0.02
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	<1%	2,310	$0.01
G8420	Bmi is documented within normal parameters and no follow-up plan is required	<1%	368	$0.01
G9744	Patient not eligible due to active diagnosis of hypertension	0%	72	$0.00
G8783	Normal blood pressure reading documented, follow-up not required	0%	550	$0.00
G9695	Long-acting inhaled bronchodilator prescribed	0%	14	$0.00
G8950	Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented	0%	421	$0.00
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	0%	51	$0.00
G8422	Bmi not documented, documentation the patient is not eligible for bmi calculation	0%	49	$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 officialPELEG, NECHEMIA (CFO, VP)