Clinic
Pacific Central Coast Health Centers
Pacific Central Coast Health Centers was paid $1.43M by Medicaid between Jan 2018 and Nov 2024, across 48 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 47% of everything it billed.
33Billing provider infoPACIFIC CENTRAL COAST HEALTH CENTERS
SANTA MARIA, CA 93454
SANTA MARIA, CA 93454
33aNPI1760723910assigned 03/13/2013
33bProvider typeCommunity Health Clinic/Center
28Total paid$1.43M
24GClaims42,723
24DCodes billed48
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Community Health Clinic/Center providers in California
Rank by total paid#159 of 288
Median peer was paid$2.15M
This provider vs. median0.7×
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 MERLO, BRANDON 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 | 5,094 | $79K | |
| 2019 | 4,643 | $136K | |
| 2020 | 5,483 | $222K | |
| 2021 | 7,360 | $323K | |
| 2022 | 7,558 | $354K | |
| 2023 | 8,641 | $203K | |
| 2024incomplete | 3,944 | $115K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 47% | 22,609 | 21,853 | $678K |
| 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 | 28% | 10,272 | 9,979 | $396K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.9% | 557 | 536 | $56K |
| 99480 | Subsequent intensive care, per day, low birth weight infant | 3.0% | 357 | 127 | $43K |
| 99479 | Subsequent intensive care, per day, very low birth weight infant | 2.1% | 255 | 76 | $30K |
| 90686 | 1.7% | 1,856 | 1,831 | $25K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.7% | 764 | 695 | $24K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.5% | 282 | 262 | $21K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 1.3% | 432 | 387 | $19K |
| 99493 | 1.2% | 122 | 122 | $17K | |
| 98926 | <1% | 381 | 354 | $14K | |
| 99469 | Subsequent inpatient neonatal critical care, per day, 28 days or younger | <1% | 34 | 12 | $13K |
36 more codes
| 92551 | <1% | 853 | $11K | |
| 99460 | <1% | 137 | $11K | |
| 99305 | <1% | 170 | $10K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 178 | $10K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 422 | $7K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 58 | $6K |
| 90648 | <1% | 303 | $3K | |
| 99173 | <1% | 959 | $3K | |
| 90674 | <1% | 121 | $3K | |
| 97802 | <1% | 26 | $3K | |
| 99462 | <1% | 72 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 98 | $3K |
| 90670 | <1% | 226 | $2K | |
| 99383 | <1% | 13 | $2K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 307 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 27 | $2K |
| 90656 | <1% | 119 | $2K | |
| 90677 | <1% | 65 | $2K | |
| 0012A | <1% | 50 | $2K | |
| 97803 | <1% | 26 | $1K | |
| 0011A | <1% | 57 | $1K | |
| 90723 | <1% | 111 | $1K | |
| 90680 | <1% | 107 | $1K | |
| 99306 | Prolong nursin fac eval 15m | <1% | 12 | $1K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 43 | $999.55 |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 38 | $971.75 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 31 | $633.38 |
| 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% | 40 | $559.42 |
| 83655 | <1% | 17 | $222.19 | |
| 90633 | <1% | 15 | $166.05 | |
| 90710 | <1% | 13 | $143.91 | |
| 90700 | <1% | 12 | $132.84 | |
| 90651 | <1% | 12 | $132.84 | |
| 96127 | <1% | 23 | $92.00 | |
| 85018 | <1% | 28 | $70.14 |
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 officialMERLO, BRANDON (CHIEF FINANCIAL OFFICER)
Parent organizationPACIFIC CENTRAL COAST HEALTH CENTERS
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.