Adventist Health Physicians Network
Adventist Health Physicians Network was paid $532K by Medicaid between Oct 2018 and Nov 2024, across 16 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 31% of everything it billed.
LODI, CA 95240
Next to other Gastroenterology 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 | 74 | $8K | |
| 2019 | 680 | $71K | |
| 2020 | 517 | $58K | |
| 2021 | 682 | $88K | |
| 2022 | 936 | $86K | |
| 2023 | 913 | $115K | |
| 2024incomplete | 1,117 | $106K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 31% | 995 | 969 | $164K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 29% | 495 | 494 | $156K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 16% | 404 | 404 | $83K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | 9.7% | 1,250 | 1,212 | $52K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 9.0% | 517 | 512 | $48K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.5% | 115 | 115 | $8K |
| 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 | 1.4% | 72 | 72 | $7K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 194 | 193 | $5K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 68 | 68 | $4K |
| 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% | 72 | 72 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 55 | 55 | $2K |
| 99153 | Mod sedat endo service >5yrs | <1% | 74 | 73 | $1K |
4 more codes
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.