Agency
South County Community Health Center INC
South County Community Health Center INC was paid $109.44M by Medicaid between Jan 2018 and Dec 2024, across 220 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 86% of everything it billed.
33Billing provider infoSOUTH COUNTY COMMUNITY HEALTH CENTER INC
EAST PALO ALTO, CA 94303
EAST PALO ALTO, CA 94303
33aNPI1821170044assigned 10/19/2006
33bProvider typeCase Management Agency
28Total paid$109.44M
24GClaims1,405,666
24DCodes billed220
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Case Management Agency providers in California
Rank by total paid#3 of 167
Median peer was paid$395K
This provider vs. median277×
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.
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 | 78,698 | $12.04M | |
| 2019 | 89,861 | $10.09M | |
| 2020 | 105,928 | $10.35M | |
| 2021 | 211,059 | $18.59M | |
| 2022 | 247,122 | $16.04M | |
| 2023 | 316,973 | $20.77M | |
| 2024incomplete | 356,025 | $21.55M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 86% | 260,789 | 220,723 | $94.54M |
| 00003 | Internal/system code - not a standard HCPCS code | 6.1% | 14,742 | 11,545 | $6.67M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.2% | 195,670 | 123,976 | $1.31M |
| 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% | 56,865 | 39,098 | $563K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 9,143 | 7,982 | $481K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 15,925 | 9,118 | $451K |
| D1310 | <1% | 15,926 | 10,627 | $398K | |
| G9012 | Other specified case management service not elsewhere classified | <1% | 3,121 | 1,476 | $318K |
| 90651 | <1% | 2,110 | 1,655 | $317K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 11,976 | 8,685 | $315K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 5,814 | 2,310 | $252K |
| D1206 | Topical application of fluoride varnish | <1% | 18,729 | 10,885 | $198K |
208 more codes
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 4,852 | $197K |
| D0120 | Dental checkup, returning patient | <1% | 14,519 | $166K |
| 90746 | <1% | 3,167 | $157K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 27,586 | $136K |
| H0049 | Alcohol and/or drug screening | <1% | 18,015 | $129K |
| D1351 | Sealant - per tooth | <1% | 4,191 | $126K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 6,639 | $117K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 928 | $100K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 2,728 | $99K |
| D0274 | Bitewings - four radiographic images | <1% | 6,713 | $94K |
| 99401 | <1% | 7,723 | $81K | |
| 92015 | Determination of refractive state | <1% | 12,813 | $76K |
| D1354 | <1% | 3,389 | $75K | |
| J3490 | Unclassified drugs | <1% | 1,960 | $73K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 7,718 | $73K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 9,292 | $71K |
| 90750 | <1% | 995 | $68K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 24,551 | $68K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 1,812 | $65K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 7,594 | $63K |
| D0140 | Limited oral evaluation - problem focused | <1% | 2,419 | $62K |
| 90677 | <1% | 2,046 | $61K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 59,925 | $57K |
| D0603 | <1% | 9,635 | $56K | |
| 90837 | Psychotherapy session, about an hour | <1% | 719 | $55K |
| D0272 | Bitewings - two radiographic images | <1% | 7,643 | $54K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 2,875 | $51K |
| D2940 | <1% | 1,222 | $47K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 1,359 | $43K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 5,022 | $41K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 6,296 | $39K |
| 81025 | <1% | 13,624 | $36K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,799 | $36K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 278 | $34K |
| 81002 | <1% | 27,115 | $34K | |
| 90686 | <1% | 15,731 | $32K | |
| D4341 | <1% | 564 | $31K | |
| D4910 | <1% | 601 | $30K | |
| D9430 | <1% | 1,978 | $30K | |
| 90756 | <1% | 1,496 | $30K | |
| 90715 | <1% | 1,583 | $28K | |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | <1% | 48 | $27K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 1,418 | $27K |
| 90688 | <1% | 4,096 | $26K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 411 | $26K |
| 11976 | <1% | 374 | $26K | |
| 97803 | <1% | 1,944 | $24K | |
| D1320 | <1% | 1,805 | $21K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 7,674 | $20K |
| 90658 | <1% | 1,136 | $20K | |
| 96156 | <1% | 1,500 | $20K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 818 | $19K |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 1,789 | $19K |
| 99000 | <1% | 48,429 | $19K | |
| 96158 | <1% | 1,254 | $18K | |
| D0330 | Panoramic radiographic image | <1% | 873 | $17K |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 1,861 | $17K |
| D1110 | Prophylaxis - adult | <1% | 477 | $17K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 331 | $17K |
| 11981 | <1% | 72 | $16K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 1,091 | $15K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 472 | $15K |
| D1352 | <1% | 532 | $13K | |
| 92250 | <1% | 419 | $13K | |
| 97802 | <1% | 546 | $13K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 1,248 | $13K |
| 90670 | <1% | 3,134 | $11K | |
| 92551 | <1% | 16,746 | $11K | |
| 90648 | <1% | 2,737 | $11K | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 927 | $9K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 551 | $9K |
| D0350 | <1% | 2,931 | $9K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 18,947 | $8K |
| 92228 | <1% | 325 | $8K | |
| S9452 | Nutrition classes, non-physician provider, per session | <1% | 625 | $8K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 514 | $7K |
| 96159 | <1% | 491 | $7K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 629 | $7K |
| 90685 | <1% | 558 | $6K | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 190 | $6K |
| 90633 | <1% | 1,830 | $6K | |
| D0270 | <1% | 1,156 | $5K | |
| 90480 | <1% | 775 | $5K | |
| V2020 | Frames, purchases | <1% | 219 | $5K |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 49 | $4K |
| 90723 | <1% | 994 | $4K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 250 | $4K |
| 96151 | <1% | 297 | $4K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 408 | $4K |
| 99429 | <1% | 144 | $4K | |
| V2750 | Anti-reflective coating, per lens | <1% | 184 | $3K |
| 99188 | <1% | 387 | $3K | |
| D0602 | <1% | 1,190 | $3K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 138 | $3K |
| 90697 | <1% | 700 | $3K | |
| 90680 | <1% | 968 | $3K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 318 | $3K |
| 90716 | <1% | 346 | $3K | |
| 90656 | <1% | 1,287 | $2K | |
| 83655 | <1% | 225 | $2K | |
| 99385 | <1% | 60 | $2K | |
| D4342 | <1% | 58 | $2K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 54 | $2K |
| 96150 | <1% | 73 | $2K | |
| T1016 | Case management, each 15 minutes | <1% | 191 | $2K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 22 | $2K |
| 99406 | <1% | 216 | $2K | |
| 90678 | <1% | 38 | $2K | |
| G9008 | Coordinated care fee, physician coordinated care oversight services | <1% | 19 | $1K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 68 | $1K |
| 85018 | <1% | 11,897 | $1K | |
| 90734 | <1% | 203 | $1K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 139 | $1K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 20 | $1K |
| T1017 | Case management, billed per 15 minutes | <1% | 72 | $1K |
| 76857 | <1% | 195 | $917.21 | |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, 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 | <1% | 129 | $889.20 |
| 11721 | <1% | 49 | $826.23 | |
| A4267 | Contraceptive supply, condom, male, each | <1% | 138 | $743.40 |
| D2950 | <1% | 26 | $732.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 80 | $688.00 |
| 92134 | <1% | 43 | $674.39 | |
| 90619 | <1% | 136 | $608.85 | |
| G0468 | Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv | <1% | 12 | $581.63 |
| 82947 | <1% | 169 | $507.50 | |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 52 | $477.33 |
| 90707 | <1% | 43 | $476.01 | |
| 90700 | <1% | 77 | $431.73 | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 29 | $382.67 |
| H2000 | Comprehensive multidisciplinary evaluation | <1% | 46 | $344.81 |
| 99070 | <1% | 140 | $312.34 | |
| D0240 | <1% | 28 | $312.00 | |
| 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% | 73 | $287.54 |
| 0071A | <1% | 13 | $268.00 | |
| 0011A | <1% | 29 | $268.00 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 1,080 | $263.90 |
| 90744 | <1% | 53 | $231.32 | |
| S4993 | Contraceptive pills for birth control | <1% | 14 | $201.12 |
| 92133 | <1% | 23 | $158.68 | |
| 90474 | <1% | 288 | $156.24 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 14 | $147.00 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 37 | $140.32 |
| 90713 | <1% | 12 | $132.84 | |
| 99397 | <1% | 21 | $129.17 | |
| 99173 | <1% | 6,707 | $127.50 | |
| 86580 | <1% | 188 | $122.70 | |
| 88720 | <1% | 192 | $64.81 | |
| 99381 | <1% | 45 | $55.76 | |
| 92552 | <1% | 35 | $33.38 | |
| 90381 | <1% | 19 | $18.00 | |
| G0008 | Administration of influenza virus vaccine | <1% | 583 | $15.09 |
| 90698 | <1% | 188 | $9.92 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 22,208 | $9.38 |
| 96160 | <1% | 540 | $2.56 | |
| 91320 | <1% | 73 | $0.06 | |
| 91322 | <1% | 53 | $0.01 | |
| 3077F | 0% | 3,958 | $0.00 | |
| 3078F | 0% | 63,946 | $0.00 | |
| Z6200 | 0% | 1,486 | $0.00 | |
| Z6300 | 0% | 1,392 | $0.00 | |
| 99411 | 0% | 2,036 | $0.00 | |
| Z6304 | 0% | 2,667 | $0.00 | |
| Z6400 | 0% | 1,515 | $0.00 | |
| Z6308 | 0% | 346 | $0.00 | |
| Z6414 | 0% | 680 | $0.00 | |
| D0191 | 0% | 3,031 | $0.00 | |
| D0707 | 0% | 1,105 | $0.00 | |
| Z6208 | 0% | 362 | $0.00 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 0% | 257 | $0.00 |
| 3015F | 0% | 59 | $0.00 | |
| D0391 | 0% | 1,101 | $0.00 | |
| D9996 | 0% | 1,969 | $0.00 | |
| 90662 | 0% | 315 | $0.00 | |
| 90710 | 0% | 34 | $0.00 | |
| 99408 | 0% | 32 | $0.00 | |
| 91312 | 0% | 12 | $0.00 | |
| 91300 | 0% | 12 | $0.00 | |
| 91313 | 0% | 45 | $0.00 | |
| 90473 | 0% | 32 | $0.00 | |
| 99442 | 0% | 24 | $0.00 | |
| 3008F | 0% | 78,448 | $0.00 | |
| Z6410 | 0% | 1,706 | $0.00 | |
| 3074F | 0% | 66,058 | $0.00 | |
| 3075F | 0% | 4,689 | $0.00 | |
| Z6204 | 0% | 2,759 | $0.00 | |
| 3079F | 0% | 12,385 | $0.00 | |
| D1330 | 0% | 9,246 | $0.00 | |
| 36416 | 0% | 420 | $0.00 | |
| Z6406 | 0% | 10,625 | $0.00 | |
| 90674 | 0% | 346 | $0.00 | |
| G0009 | Administration of pneumococcal vaccine | 0% | 53 | $0.00 |
| 90694 | 0% | 30 | $0.00 | |
| Z7610 | 0% | 42 | $0.00 | |
| 3080F | 0% | 234 | $0.00 | |
| 96161 | 0% | 31 | $0.00 | |
| 99174 | 0% | 26 | $0.00 | |
| 91306 | 0% | 13 | $0.00 | |
| 96380 | 0% | 37 | $0.00 | |
| D0708 | 0% | 1,071 | $0.00 | |
| 91301 | 0% | 25 | $0.00 | |
| 99443 | 0% | 14 | $0.00 | |
| 3072F | 0% | 38 | $0.00 | |
| 0134A | 0% | 45 | $0.00 | |
| D9920 | 0% | 48 | $0.00 | |
| G9226 | Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) | 0% | 69 | $0.00 |
| 0064A | 0% | 13 | $0.00 | |
| 9214 | 0% | 13 | $0.00 | |
| Z1034 | 0% | 43 | $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 officialJACQUES, GRALYN (CFO)