Pouya Afshar MD INC
Pouya Afshar MD INC was paid $4.61M by Medicaid between Jan 2018 and Dec 2024, across 45 billing codes. Its largest line is G9008, Coordinated care fee, physician coordinated care oversight services — 29% of everything it billed.
33Billing provider infoPOUYA AFSHAR MD INC
SAN DIEGO, CA 92108
SAN DIEGO, CA 92108
33aNPI1710336094assigned 06/08/2016
33bProvider typeSpecialist
28Total paid$4.61M
24GClaims61,855
24DCodes billed45
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in California
Rank by total paid#52 of 1,230
Median peer was paid$51K
This provider vs. median90×
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 | 5,273 | $76K | |
| 2019 | 5,157 | $102K | |
| 2020 | 5,045 | $190K | |
| 2021 | 6,294 | $390K | |
| 2022 | 7,974 | $457K | |
| 2023 | 14,026 | $1.13M | |
| 2024incomplete | 18,086 | $2.26M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G9008 | Coordinated care fee, physician coordinated care oversight services | 29% | 7,563 | 3,888 | $1.33M |
| 99494 | 13% | 3,103 | 3,022 | $585K | |
| 99493 | 10% | 4,375 | 4,372 | $476K | |
| 99350 | Prolong home eval add 15m | 9.8% | 4,836 | 4,228 | $452K |
| 99310 | Prolong nursin fac eval 15m | 6.4% | 7,101 | 5,036 | $297K |
| 99487 | Ccm add 20min | 4.3% | 1,815 | 1,811 | $200K |
| 99490 | Ccm add 20min | 3.8% | 4,285 | 4,283 | $173K |
| 99491 | Ccm add 20min | 3.0% | 2,134 | 2,132 | $139K |
| 99306 | Prolong nursin fac eval 15m | 2.8% | 1,845 | 1,829 | $129K |
| 99337 | 2.7% | 4,409 | 4,090 | $126K | |
| 99336 | 2.3% | 4,882 | 3,676 | $105K | |
| 99349 | 2.1% | 2,604 | 2,202 | $97K |
33 more codes
| G9012 | Other specified case management service not elsewhere classified | 1.9% | 386 | $89K |
| 99489 | Ccm add 20min | 1.8% | 578 | $81K |
| G2214 | Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional | 1.2% | 1,440 | $55K |
| 99335 | <1% | 2,287 | $37K | |
| 99497 | <1% | 552 | $30K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 1,604 | $30K |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | <1% | 177 | $29K |
| 99348 | <1% | 1,231 | $26K | |
| 99356 | <1% | 596 | $24K | |
| 99347 | <1% | 663 | $24K | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 140 | $18K |
| 99345 | Prolong home eval add 15m | <1% | 88 | $16K |
| 99492 | <1% | 131 | $15K | |
| 99358 | Prolong nursin fac eval 15m | <1% | 207 | $10K |
| 99484 | <1% | 93 | $4K | |
| 99344 | <1% | 28 | $3K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 215 | $2K |
| 99354 | <1% | 103 | $1K | |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | <1% | 16 | $1K |
| 99334 | <1% | 100 | $993.82 | |
| 99342 | <1% | 15 | $883.48 | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 23 | $762.33 |
| 99328 | <1% | 15 | $541.68 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 1,993 | $479.04 |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans | <1% | 12 | $201.24 |
| 90694 | <1% | 14 | $60.00 | |
| 90686 | <1% | 110 | $43.04 | |
| 11721 | <1% | 13 | $3.75 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 16 | $0.00 |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 18 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 13 | $0.00 |
| 1123F | 0% | 13 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 13 | $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 officialAFSHAR, POUYA (MEDICAL DIRECTOR)