Prohealth Partners a Medical Group INC
Prohealth Partners a Medical Group INC was paid $45K by Medicaid between Jan 2018 and Sep 2024, across 37 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 46% of everything it billed.
HAWAIIAN GARDENS, CA 90716
Next to other Family Medicine Physician providers in California
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,774 | $24K | |
| 2019 | 5,231 | $12K | |
| 2020 | 3,372 | $4K | |
| 2021 | 1,737 | $3K | |
| 2022 | 522 | $953.41 | |
| 2023 | 310 | $725.10 | |
| 2024incomplete | 810 | $696.79 |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 46% | 3,110 | 2,884 | $21K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 39% | 1,471 | 1,381 | $18K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 3.2% | 39 | 39 | $1K |
| 86580 | 1.8% | 209 | 208 | $829.36 | |
| 81002 | 1.4% | 845 | 824 | $625.85 | |
| 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 | 1.3% | 142 | 140 | $569.67 |
| 90686 | 1.2% | 190 | 190 | $531.12 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 296 | 291 | $409.26 |
| 3008F | <1% | 1,712 | 1,610 | $405.58 | |
| 81025 | <1% | 291 | 287 | $405.51 | |
| 92551 | <1% | 393 | 391 | $273.84 | |
| 85018 | <1% | 690 | 687 | $244.22 |
25 more codes
| 92081 | <1% | 298 | $230.44 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,492 | $195.88 |
| 3074F | <1% | 563 | $167.40 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 41 | $152.71 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 136 | $142.33 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 44 | $100.50 |
| 1036F | <1% | 448 | $77.64 | |
| 90688 | <1% | 12 | $77.38 | |
| 90658 | <1% | 13 | $74.00 | |
| 99000 | <1% | 15 | $53.01 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 29 | $50.03 |
| 3049F | <1% | 12 | $46.98 | |
| 3080F | <1% | 70 | $23.49 | |
| 81000 | <1% | 13 | $5.42 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 99 | $0.02 |
| 3077F | 0% | 45 | $0.00 | |
| 99442 | 0% | 112 | $0.00 | |
| 3078F | 0% | 262 | $0.00 | |
| 90687 | 0% | 12 | $0.00 | |
| 82947 | 0% | 13 | $0.00 | |
| 3079F | 0% | 169 | $0.00 | |
| 99441 | 0% | 166 | $0.00 | |
| 3044F | 0% | 258 | $0.00 | |
| 3048F | 0% | 32 | $0.00 | |
| 3075F | 0% | 14 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.