Physician
Providence Saint Johns Medical Foundation
Providence Saint Johns Medical Foundation was paid $1.05M by Medicaid between Jul 2018 and Nov 2024, across 30 billing codes. Its largest line is 99233, hospital visit by a doctor, follow-up day (complex) — 25% of everything it billed.
33Billing provider infoPROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
SANTA MONICA, CA 90404
SANTA MONICA, CA 90404
33aNPI1770093734assigned 10/04/2017
33bProvider typeFamily Medicine Physician
28Total paid$1.05M
24GClaims37,385
24DCodes billed30
24AFirst – last monthJul 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in California
Rank by total paid#162 of 2,511
Median peer was paid$13K
This provider vs. median82×
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 | 2,580 | $54K | |
| 2019 | 4,739 | $154K | |
| 2020 | 4,880 | $174K | |
| 2021 | 5,497 | $198K | |
| 2022 | 3,795 | $135K | |
| 2023 | 5,168 | $175K | |
| 2024incomplete | 10,726 | $162K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 25% | 9,536 | 3,056 | $261K |
| 99223 | Prolong inpt eval add15 m | 16% | 2,685 | 2,301 | $170K |
| 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 | 16% | 5,824 | 5,347 | $167K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 13% | 7,015 | 2,432 | $141K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 8.4% | 2,312 | 2,111 | $88K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 7.2% | 1,917 | 1,865 | $75K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.5% | 2,192 | 1,968 | $37K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 2.2% | 223 | 115 | $23K |
| 99222 | Initial hospital care, per day, moderate complexity | 2.1% | 616 | 563 | $23K |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.1% | 1,017 | 968 | $22K |
| 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 | 1.2% | 429 | 426 | $13K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 1,104 | 941 | $7K |
18 more codes
| 93000 | <1% | 1,154 | $6K | |
| 99205 | Prolong outpt/office vis | <1% | 156 | $5K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 144 | $4K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 112 | $3K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 68 | $2K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 437 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 13 | $654.98 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 110 | $517.18 |
| 99221 | <1% | 12 | $488.18 | |
| 93294 | <1% | 24 | $162.87 | |
| 3078F | 0% | 15 | $0.00 | |
| 90653 | 0% | 12 | $0.00 | |
| 93356 | 0% | 13 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 12 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 162 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 16 | $0.00 |
| 1036F | 0% | 28 | $0.00 | |
| 3074F | 0% | 27 | $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.