Sequoia Health Ipa INC

Sequoia Health Ipa INC was paid $43.41M by Medicaid between Jan 2018 and Dec 2024, across 342 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 16% of everything it billed.

33Billing provider infoSEQUOIA HEALTH IPA INC
CORONA, CA 92881

33aNPI1851821565assigned 06/14/2017

33bProvider typeHealth Maintenance Organization

28Total paid$43.41M

24GClaims2,441,766

24DCodes billed342

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Health Maintenance Organization providers in California

Rank by total paid#3 of 151

Median peer was paid$59K

This provider vs. median735×

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	224,347	$3.31M
2019	359,327	$5.82M
2020	348,804	$5.37M
2021	315,248	$6.12M
2022	356,859	$7.61M
2023	419,322	$8.08M
2024incomplete	417,859	$7.11M

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	16%	622,466	574,660	$6.80M
59425		13%	68,860	50,863	$5.64M
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	7.7%	200,279	189,905	$3.35M
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	5.8%	152,895	151,752	$2.53M
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	4.4%	242,930	222,480	$1.92M
90791	Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation	3.7%	10,787	10,382	$1.62M
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	3.6%	24,867	23,277	$1.55M
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	2.6%	46,543	46,245	$1.14M
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.4%	32,264	32,211	$1.04M
59409	Vaginal delivery only (with or without episiotomy and/or forceps)	2.4%	1,368	1,366	$1.03M
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	2.3%	30,435	29,942	$1.02M
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	1.9%	15,599	15,564	$825K

330 more codes

99460		1.5%	9,397	$647K
98940		1.3%	22,722	$585K
98941	Chiropractic manipulative treatment; spinal, 3-4 regions	1.2%	22,443	$520K
90651		1.1%	12,674	$491K
90746		1.1%	6,723	$488K
90686		1.1%	43,323	$486K
90715		1.1%	14,959	$462K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	1.1%	15,299	$458K
90677		1.1%	6,879	$456K
92551		1.0%	64,918	$446K
99462		<1%	11,400	$418K
J3490	Unclassified drugs	<1%	6,030	$398K
99215	Doctor's office visit, returning patient (complex)	<1%	4,638	$378K
99203	Doctor's office visit, new patient (routine)	<1%	11,766	$366K
H1003	Prenatal care, at-risk enhanced service; education	<1%	13,797	$308K
99205	Prolong outpt/office vis	<1%	2,078	$292K
59025	Fetal non-stress test	<1%	8,048	$292K
99238	Hospital discharge day management, 30 minutes or less	<1%	5,290	$286K
90656		<1%	26,491	$277K
90670		<1%	25,649	$276K
99173		<1%	71,976	$274K
59514		<1%	434	$247K
90750		<1%	1,261	$230K
59430		<1%	2,970	$226K
99385		<1%	4,754	$217K
90620		<1%	4,047	$182K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	26,277	$181K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	7,046	$173K
81003		<1%	88,786	$168K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	8,276	$160K
99283	Emergency room visit (moderate)	<1%	4,238	$159K
85018		<1%	75,259	$151K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	11,416	$150K
99222	Initial hospital care, per day, moderate complexity	<1%	1,505	$149K
97140	Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage)	<1%	2,604	$148K
D1206	Topical application of fluoride varnish	<1%	5,548	$136K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	<1%	123	$131K
97802		<1%	3,775	$127K
81025		<1%	41,109	$117K
90723		<1%	17,558	$113K
90647		<1%	16,684	$112K
0500F		<1%	525	$98K
90792	Psychiatric diagnostic evaluation with medical services	<1%	899	$98K
99401		<1%	6,974	$98K
90633		<1%	16,577	$97K
11721		<1%	2,916	$90K
99284	Emergency room visit (serious)	<1%	1,624	$88K
83036	Hemoglobin; glycosylated (A1C)	<1%	8,294	$88K
99232	Hospital visit by a doctor, follow-up day	<1%	2,139	$85K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	12,553	$81K
99386		<1%	2,388	$79K
36415	Collection of venous blood by venipuncture	<1%	7,868	$78K
90716		<1%	4,006	$72K
99285	Emergency room visit (most serious)	<1%	772	$72K
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	<1%	3,061	$65K
99204	Doctor's office visit, new patient (more involved)	<1%	1,865	$61K
90734		<1%	4,892	$57K
80061	Lipid panel	<1%	3,602	$56K
77067	Screening mammography, bilateral, including computer-aided detection	<1%	545	$51K
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	<1%	863	$50K
99188		<1%	2,561	$50K
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	1,011	$48K
97139		<1%	2,178	$48K
88175	Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer	<1%	1,130	$47K
90707		<1%	2,891	$44K
87491	Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe	<1%	1,429	$43K
11056		<1%	1,724	$39K
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	2,844	$35K
97803		<1%	2,413	$34K
99444		<1%	498	$34K
92250		<1%	1,510	$33K
99223	Prolong inpt eval add15 m	<1%	344	$31K
90710		<1%	3,932	$30K
84439		<1%	1,300	$29K
99381		<1%	351	$28K
87811	Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19)	<1%	769	$27K
90681		<1%	2,850	$25K
96156		<1%	1,675	$25K
90696		<1%	3,457	$25K
90688		<1%	2,172	$23K
90619		<1%	1,829	$23K
90700		<1%	2,599	$22K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed	<1%	116	$21K
58300		<1%	229	$20K
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	484	$19K
87088		<1%	676	$19K
99000		<1%	4,806	$19K
11981		<1%	94	$19K
99384		<1%	253	$18K
93306	Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete	<1%	165	$17K
86038		<1%	368	$16K
82728		<1%	407	$16K
97750		<1%	534	$15K
90732		<1%	178	$15K
90662		<1%	284	$15K
97799		<1%	647	$15K
90680		<1%	2,734	$14K
87340		<1%	399	$14K
11730		<1%	248	$14K
83655		<1%	1,076	$14K
95811		<1%	55	$13K
86580		<1%	3,729	$13K
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	1,035	$13K
88305	Level IV - Surgical pathology, gross and microscopic examination	<1%	148	$12K
99402		<1%	1,416	$12K
86704		<1%	237	$11K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	<1%	132	$11K
90834	Psychotherapy session, about 45 minutes	<1%	143	$11K
82962		<1%	5,400	$11K
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	1,425	$11K
76830	Ultrasound, transvaginal	<1%	163	$10K
90380		<1%	33	$10K
99242		<1%	72	$10K
95810	Polysomnography; sleep staging with 4 or more additional parameters	<1%	55	$9K
99383		<1%	161	$9K
90649		<1%	168	$9K
76856	Ultrasound, pelvic (nonobstetric), real time with image documentation; complete	<1%	208	$8K
82746		<1%	234	$8K
94200		<1%	533	$8K
81420	Fetal chromosomal aneuploidy genomic sequence analysis panel	<1%	13	$8K
90837	Psychotherapy session, about an hour	<1%	79	$8K
90713		<1%	831	$8K
71046	Radiologic examination, chest; 2 views	<1%	680	$8K
82947		<1%	318	$8K
11720		<1%	388	$8K
11057		<1%	331	$8K
99403		<1%	166	$7K
81220	CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants	<1%	60	$7K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	865	$7K
96150		<1%	426	$7K
97014		<1%	1,629	$7K
G0442	Annual alcohol misuse screening, 5 to 15 minutes	<1%	631	$7K
86695		<1%	278	$6K
93000		<1%	623	$6K
96151		<1%	565	$6K
80305		<1%	556	$6K
T4541	Incontinence product, disposable underpad, large, each	<1%	300	$6K
86703		<1%	1,069	$6K
99239	Hospital discharge day management, more than 30 minutes	<1%	111	$6K
97161		<1%	294	$6K
90714		<1%	177	$5K
82652		<1%	184	$5K
85027		<1%	1,856	$5K
85652		<1%	503	$5K
83001		<1%	93	$5K
83013		<1%	305	$5K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	3,716	$5K
97112	Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination	<1%	1,254	$5K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	117	$5K
76700	Ultrasound, abdominal, real time with image documentation; complete	<1%	96	$5K
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	<1%	147	$5K
99201		<1%	456	$5K
72148	Magnetic resonance imaging, lumbar spine; without contrast material	<1%	26	$4K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	<1%	208	$4K
76642		<1%	65	$4K
87591	Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe	<1%	1,420	$4K
87086	Culture, bacterial; quantitative colony count, urine	<1%	1,019	$4K
87522	Neg quan hep c or qual rna	<1%	182	$4K
73721	Magnetic resonance imaging, any joint of lower extremity; without contrast material	<1%	17	$4K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed	<1%	313	$4K
70450	Computed tomography, head or brain; without contrast material	<1%	91	$3K
86850		<1%	124	$3K
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	455	$3K
82274		<1%	298	$3K
99243		<1%	54	$3K
95117		<1%	650	$3K
97001		<1%	45	$3K
90685		<1%	372	$3K
H0049	Alcohol and/or drug screening	<1%	142	$2K
84403		<1%	125	$2K
84443	Thyroid stimulating hormone (TSH)	<1%	3,167	$2K
90744		<1%	728	$2K
58301		<1%	74	$2K
84466		<1%	225	$2K
69209		<1%	192	$2K
11976		<1%	24	$2K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	<1%	196	$2K
73630		<1%	157	$2K
72110		<1%	69	$2K
80053	Comprehensive metabolic panel	<1%	4,380	$2K
73564		<1%	130	$2K
71045	Radiologic examination, chest; single view	<1%	303	$2K
11042	Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm	<1%	27	$2K
17110		<1%	34	$2K
85610		<1%	927	$2K
90648		<1%	2,124	$2K
11055		<1%	112	$2K
93970		<1%	14	$2K
83735		<1%	179	$2K
11750		<1%	24	$2K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	<1%	27	$2K
86480		<1%	169	$2K
74177	Computed tomography, abdomen and pelvis; with contrast material	<1%	32	$2K
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	<1%	239	$2K
76705	Ultrasound, abdominal, real time with image documentation; limited	<1%	34	$2K
82784		<1%	49	$2K
87205		<1%	62	$2K
81001		<1%	980	$2K
84146		<1%	100	$1K
87070		<1%	448	$1K
82465		<1%	12	$1K
76801		<1%	62	$1K
85730		<1%	151	$1K
82570		<1%	930	$1K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	<1%	13	$1K
80048	Basic metabolic panel (calcium, ionized)	<1%	534	$1K
86200		<1%	173	$1K
86592		<1%	690	$1K
83970		<1%	104	$950.06
96158		<1%	102	$931.96
A4267	Contraceptive supply, condom, male, each	<1%	112	$907.10
83690		<1%	169	$741.78
82627		<1%	42	$715.45
87660		<1%	13	$702.39
86803		<1%	704	$701.55
90480		<1%	17	$680.00
A6250	Skin sealants, protectants, moisturizers, ointments, any type, any size	<1%	150	$621.69
83014		<1%	237	$610.11
87389	Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies	<1%	1,213	$587.54
92552		<1%	39	$547.99
84460		<1%	242	$526.98
78452	Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress	<1%	17	$517.00
87209		<1%	14	$511.04
84132		<1%	110	$506.22
86787		<1%	164	$494.97
S9452	Nutrition classes, non-physician provider, per session	<1%	51	$491.10
90381		<1%	27	$486.00
87081		<1%	218	$475.51
86780		<1%	12	$469.51
86003		<1%	94	$464.10
82607		<1%	341	$448.13
87624	Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types	<1%	503	$443.08
87046		<1%	12	$439.10
84550		<1%	137	$436.09
93016		<1%	26	$425.72
83540		<1%	372	$425.30
73610		<1%	39	$420.30
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	<1%	12	$413.90
81002		<1%	170	$402.99
86376		<1%	34	$369.84
73030		<1%	20	$358.31
92229		<1%	15	$337.57
82310		<1%	85	$332.76
90698		<1%	730	$299.25
82550		<1%	88	$292.35
87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	<1%	86	$272.07
97530	Therapeutic activities, direct patient contact, each 15 minutes	<1%	61	$261.37
84479		<1%	24	$259.06
86706		<1%	56	$231.51
88720		<1%	51	$223.89
86708		<1%	250	$220.87
84436		<1%	78	$195.45
86431		<1%	238	$183.52
82785		<1%	14	$179.22
86901		<1%	44	$160.24
80074		<1%	221	$149.61
82248		<1%	132	$143.63
85045		<1%	53	$135.24
83921		<1%	12	$117.44
G0467	Community health center visit, returning patient	<1%	234	$97.27
92225		<1%	16	$96.54
84702		<1%	68	$93.75
83002		<1%	87	$90.74
84100		<1%	191	$83.53
80081		<1%	145	$81.58
95115		<1%	15	$76.65
86140		<1%	397	$75.97
87040		<1%	71	$69.97
87075		<1%	60	$61.16
J7613	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	<1%	759	$58.72
82565		<1%	118	$51.05
99382		<1%	12	$47.13
87077		<1%	261	$44.38
84484		<1%	107	$42.31
84156		<1%	137	$34.90
84075		<1%	83	$33.57
84481		<1%	13	$29.73
82040		<1%	59	$27.87
83516		<1%	29	$25.80
85007		<1%	185	$18.33
84450		<1%	185	$17.98
84153		<1%	43	$16.47
84295		<1%	43	$14.56
86317		<1%	206	$13.52
84520		<1%	110	$13.18
80076		<1%	137	$12.76
83880		<1%	67	$12.12
82553		<1%	51	$11.68
J2001	Injection, lidocaine hcl for intravenous infusion, 10 mg	<1%	32	$5.41
86900		<1%	31	$2.16
3078F		0%	2,857	$0.00
3077F		0%	4,427	$0.00
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	0%	8,122	$0.00
90472	Immunization administration, each additional vaccine (list separately)	0%	1,228	$0.00
87186		0%	280	$0.00
99051		0%	237	$0.00
86696		0%	280	$0.00
82247		0%	57	$0.00
87045		0%	12	$0.00
76805	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation	0%	42	$0.00
85014		0%	27	$0.00
87177		0%	14	$0.00
S4993	Contraceptive pills for birth control	0%	12	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	24,964	$0.00
3074F		0%	2,020	$0.00
3080F		0%	1,785	$0.00
3079F		0%	3,076	$0.00
80069		0%	110	$0.00
3075F		0%	1,313	$0.00
83605		0%	26	$0.00
97010		0%	1,889	$0.00
94760		0%	447	$0.00
83550		0%	352	$0.00
87147		0%	84	$0.00
76816	Ultrasound, pregnant uterus, real time with image documentation, follow-up	0%	194	$0.00
82043		0%	748	$0.00
87510		0%	13	$0.00
H0033	Oral medication administration, direct observation	0%	104	$0.00
A4335	Incontinence supply; miscellaneous	0%	96	$0.00
76811	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed	0%	68	$0.00
Q3014	Telehealth originating site facility fee	0%	58	$0.00
T1014	Telehealth transmission, per minute, professional services bill separately	0%	58	$0.00
82951		0%	87	$0.00
81000		0%	18	$0.00
R0070	Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen	0%	17	$0.00
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	0%	14	$0.00
87480		0%	13	$0.00
88141		0%	27	$0.00
82435		0%	14	$0.00
Q0092	Set-up portable x-ray equipment	0%	17	$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 officialKLAREN, JAY (SR DIRECTOR, PROGRAM DEV & PLANNING)