Physician
Providence Medical Institute
Providence Medical Institute was paid $3.57M by Medicaid between Jan 2018 and Dec 2024, across 130 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 18% of everything it billed.
33Billing provider infoPROVIDENCE MEDICAL INSTITUTE
TORRANCE, CA 90503
TORRANCE, CA 90503
33aNPI1760425862assigned 06/14/2006
33bProvider typePediatrics Physician
28Total paid$3.57M
24GClaims202,060
24DCodes billed130
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in California
Rank by total paid#43 of 1,490
Median peer was paid$15K
This provider vs. median238×
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.
Entity ProliferationAuthorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more
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 | 35,029 | $308K | |
| 2019 | 43,124 | $597K | |
| 2020 | 35,510 | $548K | |
| 2021 | 17,254 | $525K | |
| 2022 | 15,023 | $421K | |
| 2023 | 22,878 | $592K | |
| 2024incomplete | 33,242 | $576K |
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 | 18% | 42,957 | 39,649 | $625K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 13% | 19,747 | 5,774 | $461K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 13% | 13,475 | 13,421 | $456K |
| 99223 | Prolong inpt eval add15 m | 9.5% | 6,517 | 6,232 | $339K |
| 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 | 5.8% | 3,501 | 3,492 | $207K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 5.4% | 8,347 | 3,771 | $194K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.3% | 17,589 | 16,795 | $188K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.2% | 2,811 | 2,809 | $114K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.2% | 2,383 | 2,376 | $77K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.0% | 11,135 | 10,055 | $71K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.7% | 1,811 | 1,529 | $60K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.7% | 1,531 | 1,530 | $60K |
118 more codes
| 99222 | Initial hospital care, per day, moderate complexity | 1.7% | 1,140 | $60K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.6% | 1,759 | $57K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1.5% | 739 | $54K |
| 99215 | Doctor's office visit, returning patient (complex) | 1.5% | 1,644 | $52K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 1.4% | 425 | $49K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.4% | 959 | $48K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 3,604 | $33K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 216 | $27K |
| 92551 | <1% | 2,915 | $26K | |
| 99205 | Prolong outpt/office vis | <1% | 343 | $25K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 557 | $24K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 204 | $24K |
| 93000 | <1% | 3,455 | $20K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,243 | $16K |
| 90686 | <1% | 3,001 | $15K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 884 | $13K |
| Z1034 | <1% | 255 | $13K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 95 | $11K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 624 | $11K |
| 90670 | <1% | 1,179 | $10K | |
| 59025 | Fetal non-stress test | <1% | 1,204 | $8K |
| 90651 | <1% | 454 | $8K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,941 | $7K |
| 99459 | <1% | 526 | $6K | |
| 90680 | <1% | 681 | $6K | |
| 90633 | <1% | 700 | $6K | |
| 93296 | <1% | 402 | $6K | |
| 99152 | <1% | 578 | $5K | |
| 90698 | <1% | 594 | $5K | |
| 99255 | <1% | 70 | $5K | |
| 93016 | <1% | 362 | $4K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 155 | $4K |
| 90744 | <1% | 344 | $3K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 214 | $3K |
| 93294 | <1% | 379 | $3K | |
| 20610 | <1% | 502 | $3K | |
| 93018 | <1% | 369 | $3K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,527 | $2K |
| 99283 | Emergency room visit (moderate) | <1% | 102 | $2K |
| 99220 | <1% | 29 | $2K | |
| 59514 | <1% | 13 | $2K | |
| 99381 | <1% | 42 | $2K | |
| 93308 | <1% | 117 | $2K | |
| 90707 | <1% | 147 | $2K | |
| 99383 | <1% | 28 | $2K | |
| 90715 | <1% | 171 | $1K | |
| 90734 | <1% | 159 | $1K | |
| 90716 | <1% | 140 | $1K | |
| 85018 | <1% | 1,223 | $1K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 62 | $1K |
| 59425 | <1% | 486 | $1K | |
| 93015 | <1% | 81 | $1K | |
| 99221 | <1% | 70 | $1K | |
| 93295 | <1% | 84 | $1K | |
| 90696 | <1% | 116 | $1K | |
| 90710 | <1% | 110 | $990.00 | |
| 90700 | <1% | 112 | $972.00 | |
| 80053 | Comprehensive metabolic panel | <1% | 3,668 | $970.16 |
| 90656 | <1% | 138 | $965.03 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $936.90 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 4,438 | $856.02 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 672 | $824.60 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 450 | $713.56 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 29 | $687.32 |
| 90461 | <1% | 637 | $648.00 | |
| 99451 | <1% | 52 | $626.75 | |
| 97803 | <1% | 121 | $592.91 | |
| 90648 | <1% | 65 | $576.00 | |
| 90697 | <1% | 61 | $549.00 | |
| 93321 | <1% | 64 | $449.62 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 10,817 | $440.17 |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 52 | $353.22 |
| 59430 | <1% | 12 | $302.40 | |
| 96151 | <1% | 33 | $185.02 | |
| 73562 | <1% | 28 | $182.52 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,739 | $174.30 |
| 1036F | <1% | 425 | $140.90 | |
| 0298T | <1% | 14 | $129.54 | |
| 93325 | <1% | 92 | $128.10 | |
| 90653 | <1% | 82 | $126.70 | |
| 93288 | <1% | 13 | $114.18 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 139 | $58.28 |
| 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% | 821 | $43.38 |
| 73560 | <1% | 49 | $28.43 | |
| 83615 | <1% | 190 | $26.76 | |
| 96127 | <1% | 24 | $19.65 | |
| 99442 | <1% | 413 | $18.67 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 12 | $11.58 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 676 | $8.45 |
| 81003 | <1% | 358 | $6.88 | |
| 99173 | <1% | 731 | $3.12 | |
| 36416 | 0% | 166 | $0.00 | |
| 3074F | 0% | 332 | $0.00 | |
| 96161 | 0% | 278 | $0.00 | |
| 99443 | 0% | 33 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 99 | $0.00 |
| 87110 | 0% | 45 | $0.00 | |
| 99441 | 0% | 190 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 146 | $0.00 |
| 87070 | 0% | 15 | $0.00 | |
| 3079F | 0% | 41 | $0.00 | |
| 82962 | 0% | 39 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 14 | $0.00 |
| 0501F | 0% | 15 | $0.00 | |
| 93351 | 0% | 13 | $0.00 | |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 15 | $0.00 |
| 81025 | 0% | 47 | $0.00 | |
| 81002 | 0% | 100 | $0.00 | |
| 90662 | 0% | 73 | $0.00 | |
| 80061 | Lipid panel | 0% | 731 | $0.00 |
| 3078F | 0% | 245 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 118 | $0.00 |
| 0502F | 0% | 358 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 420 | $0.00 |
| 91320 | 0% | 18 | $0.00 | |
| 73030 | 0% | 13 | $0.00 | |
| 82652 | 0% | 13 | $0.00 | |
| 3077F | 0% | 16 | $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 officialANDERSON, DONALD (ASSISTANT SECRETARY OF ENROLLMENTS)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.