Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › CA › Brea › NPI 1871607762
Clinic

Providence Medical Foundation

Providence Medical Foundation was paid $52.59M by Medicaid between Jan 2018 and Dec 2024, across 331 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 14% of everything it billed.

33Billing provider infoPROVIDENCE MEDICAL FOUNDATION
BREA, CA 92821
33aNPI1871607762assigned 08/18/2006
33bProvider typeRadiology Clinic/Center
28Total paid$52.59M
24GClaims1,646,014
24DCodes billed331
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Radiology Clinic/Center providers in California

Rank by total paid#2 of 94
Median peer was paid$120K
This provider vs. median439×

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

$0$500K$1.0M$1.5M2018201920202021202220232024
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
YearClaimsPaid
2018112,651$4.35M
2019177,882$6.14M
2020173,958$6.09M
2021211,440$7.12M
2022266,550$8.41M
2023352,416$9.86M
2024incomplete351,117$10.62M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 14% 249,770 236,807 $7.23M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9.2% 242,541 230,384 $4.85M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 5.9% 38,251 37,613 $3.12M
H1001 Prenatal care, at-risk enhanced service; antepartum management 5.5% 31,731 21,070 $2.90M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 5.4% 24,718 11,462 $2.84M
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 5.3% 81,866 32,685 $2.76M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 5.0% 62,153 26,018 $2.62M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 4.7% 31,365 30,828 $2.46M
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2.9% 28,068 27,927 $1.54M
S9083 Global fee urgent care centers 2.9% 27,856 25,047 $1.50M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 2.7% 26,717 26,194 $1.41M
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 2.4% 15,720 15,567 $1.24M
319 more codes
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 2.3% 92,188 $1.19M
96156 2.0% 12,770 $1.07M
99215 Doctor's office visit, returning patient (complex) 2.0% 19,261 $1.05M
99223 Prolong inpt eval add15 m 1.9% 14,584 $1.02M
59425 1.6% 10,301 $852K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1.2% 16,673 $606K
99222 Initial hospital care, per day, moderate complexity 1.1% 9,233 $600K
J0585 Injection, onabotulinumtoxina, 1 unit 1.1% 802 $556K
95144 <1% 703 $523K
99239 Hospital discharge day management, more than 30 minutes <1% 11,169 $453K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 10,417 $422K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 9,565 $404K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 1,541 $395K
77067 Screening mammography, bilateral, including computer-aided detection <1% 2,841 $388K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 11,514 $371K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 7,418 $369K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 16,184 $361K
99205 Prolong outpt/office vis <1% 3,317 $348K
99285 Emergency room visit (most serious) <1% 2,441 $277K
93000 <1% 11,344 $273K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 4,217 $258K
Z1034 <1% 4,747 $258K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 1,865 $238K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 398 $191K
99244 Office or other outpatient consultation, moderate to high complexity <1% 1,279 $180K
95811 <1% 746 $179K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 12,441 $177K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 5,125 $165K
99243 <1% 1,429 $155K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 2,105 $145K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) <1% 194 $137K
99238 Hospital discharge day management, 30 minutes or less <1% 3,744 $135K
90686 <1% 14,137 $126K
G9920 Screening performed and negative <1% 9,300 $122K
H1000 Prenatal care, at-risk assessment <1% 695 $116K
59430 <1% 1,274 $112K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits <1% 973 $107K
92551 <1% 8,938 $101K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 600 $99K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 277 $92K
96151 <1% 4,086 $91K
95117 <1% 5,135 $88K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 3,314 $85K
G6015 Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session <1% 586 $84K
99255 <1% 823 $79K
71046 Radiologic examination, chest; 2 views <1% 3,350 $76K
G8510 Screening for depression is documented as negative, a follow-up plan is not required <1% 35,563 $75K
90670 <1% 8,293 $72K
99245 <1% 437 $70K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 3,234 $69K
59025 Fetal non-stress test <1% 5,026 $67K
99254 <1% 854 $60K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results <1% 1,084 $58K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 237 $58K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose <1% 298 $53K
90723 <1% 5,975 $53K
77427 <1% 678 $49K
17110 <1% 571 $47K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 16,851 $46K
99221 <1% 1,785 $45K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 630 $42K
90633 <1% 5,150 $42K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 2,914 $41K
90651 <1% 3,667 $41K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 508 $41K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 10,334 $41K
J2785 Injection, regadenoson, 0.1 mg <1% 276 $40K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 389 $39K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 4,137 $38K
76641 <1% 276 $37K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 408 $37K
90647 <1% 4,664 $37K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 4,435 $36K
73610 <1% 1,561 $36K
90837 Psychotherapy session, about an hour <1% 314 $36K
90715 <1% 2,641 $36K
73110 <1% 1,496 $34K
93299 <1% 477 $30K
G9012 Other specified case management service not elsewhere classified <1% 961 $28K
93298 <1% 813 $25K
90734 <1% 3,185 $24K
20553 <1% 298 $24K
93016 <1% 1,067 $24K
93297 <1% 981 $23K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 11,141 $23K
95806 <1% 123 $22K
90681 <1% 2,397 $22K
90700 <1% 2,443 $21K
90707 <1% 2,325 $21K
99308 Subsequent nursing facility care, per day, straightforward <1% 1,957 $21K
90716 <1% 2,313 $21K
76642 <1% 229 $21K
76830 Ultrasound, transvaginal <1% 265 $21K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 51 $20K
99000 <1% 6,153 $20K
97010 <1% 1,715 $20K
90710 <1% 2,397 $20K
77066 Tomosynthesis, mammo <1% 119 $20K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 622 $20K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose <1% 134 $19K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 5,155 $19K
90696 <1% 2,104 $18K
80053 Comprehensive metabolic panel <1% 1,875 $17K
96150 <1% 736 $17K
93018 <1% 967 $17K
73130 <1% 689 $16K
29075 <1% 128 $16K
20610 <1% 736 $16K
90620 <1% 984 $16K
99442 <1% 4,270 $16K
99385 <1% 252 $16K
59514 <1% 35 $16K
85018 <1% 8,870 $15K
73630 <1% 700 $15K
72100 <1% 461 $14K
99292 <1% 292 $14K
99460 <1% 205 $14K
83655 <1% 1,497 $14K
99383 <1% 317 $14K
99492 <1% 105 $14K
99493 <1% 184 $13K
76942 <1% 332 $13K
93015 <1% 147 $13K
97014 <1% 946 $13K
81002 <1% 18,456 $13K
90648 <1% 1,330 $12K
77336 <1% 366 $12K
93017 <1% 257 $12K
73562 <1% 476 $11K
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% 3,958 $11K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 56 $11K
94729 <1% 483 $11K
90791 Psychiatric diagnostic evaluation <1% 82 $11K
96375 Therapeutic injection; each additional sequential IV push <1% 183 $11K
84443 Thyroid stimulating hormone (TSH) <1% 723 $10K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 422 $10K
99497 <1% 94 $10K
73030 <1% 470 $10K
95911 <1% 42 $10K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 297 $9K
G8431 Screening for depression is documented as being positive and a follow-up plan is documented <1% 763 $9K
92557 <1% 131 $9K
92552 <1% 805 $9K
99152 <1% 205 $9K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit <1% 525 $9K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 397 $9K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 1,729 $9K
90834 Psychotherapy session, about 45 minutes <1% 123 $8K
90680 <1% 940 $8K
90677 <1% 666 $8K
94010 <1% 214 $8K
95909 <1% 39 $8K
29405 <1% 56 $8K
99441 <1% 1,765 $8K
99443 <1% 1,261 $7K
80061 Lipid panel <1% 646 $7K
64615 <1% 55 $7K
94060 <1% 317 $7K
G9008 Coordinated care fee, physician coordinated care oversight services <1% 14,012 $7K
73564 <1% 243 $7K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 46 $7K
81025 <1% 9,174 $7K
64405 <1% 82 $7K
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf <1% 140 $6K
96127 <1% 2,087 $6K
77014 <1% 150 $6K
77065 Tomosynthesis, mammo <1% 52 $6K
51798 <1% 94 $6K
99253 <1% 124 $6K
83036 Hemoglobin; glycosylated (A1C) <1% 734 $6K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 1,997 $6K
77063 Screening digital breast tomosynthesis, bilateral <1% 113 $6K
25600 <1% 24 $6K
93294 <1% 347 $6K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 421 $6K
97750 <1% 158 $5K
95115 <1% 642 $5K
99384 <1% 109 $5K
77080 <1% 180 $5K
90656 <1% 765 $5K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 110 $5K
99382 <1% 82 $5K
90961 <1% 271 $5K
J0897 Injection, denosumab, 1 mg <1% 15 $5K
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 1,430 $5K
99242 <1% 57 $5K
94727 <1% 145 $4K
84439 <1% 570 $4K
99381 <1% 76 $4K
29065 <1% 28 $4K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 5,843 $4K
92504 <1% 163 $4K
88141 <1% 71 $4K
99220 <1% 67 $3K
69210 <1% 130 $3K
62323 <1% 13 $3K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 114 $3K
J1580 Injection, garamycin, gentamicin, up to 80 mg <1% 644 $3K
99306 Prolong nursin fac eval 15m <1% 182 $3K
99451 <1% 80 $3K
Z1032 <1% 24 $3K
82962 <1% 2,314 $3K
94375 <1% 63 $3K
93245 <1% 25 $3K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg <1% 1,659 $3K
76770 <1% 26 $3K
99356 <1% 66 $3K
77334 <1% 32 $2K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 581 $2K
93248 <1% 99 $2K
99218 <1% 81 $2K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 59 $2K
73080 <1% 87 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 1,295 $2K
99386 <1% 39 $2K
94726 <1% 157 $2K
93880 <1% 13 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 2,624 $2K
99406 <1% 221 $2K
92550 <1% 58 $2K
90685 <1% 196 $2K
95251 <1% 67 $2K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 30 $2K
90832 Psychotherapy session, about 30 minutes <1% 26 $2K
31575 <1% 13 $2K
76536 <1% 27 $2K
97035 <1% 170 $1K
99072 <1% 302 $1K
93296 <1% 180 $1K
81003 <1% 5,049 $1K
99173 <1% 1,686 $1K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 165 $1K
99494 <1% 14 $1K
93308 <1% 33 $1K
31231 <1% 12 $1K
99217 <1% 55 $1K
99153 Mod sedat endo service >5yrs <1% 30 $1K
77263 <1% 12 $1K
93295 <1% 28 $1K
72040 <1% 37 $992.48
95800 <1% 26 $992.00
73100 <1% 58 $986.10
G0008 Administration of influenza virus vaccine <1% 677 $940.59
11721 <1% 210 $901.25
77300 <1% 17 $879.54
95717 <1% 13 $870.78
J1071 Injection, testosterone cypionate, 1 mg <1% 208 $865.89
93280 <1% 100 $842.01
90688 <1% 136 $833.83
93246 <1% 57 $817.26
69209 <1% 294 $707.15
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg <1% 45 $606.67
0001A <1% 15 $600.00
99172 <1% 31 $570.40
0002A <1% 14 $560.00
90697 <1% 12 $529.17
0031A <1% 13 $520.00
12001 <1% 28 $516.28
81001 <1% 195 $491.72
90480 <1% 12 $480.00
76937 <1% 29 $476.80
90662 <1% 285 $465.75
86580 <1% 109 $449.05
3074F <1% 37,483 $437.50
96402 <1% 27 $417.42
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 702 $392.60
G9919 Screening performed and positive and provision of recommendations <1% 13 $377.00
93356 <1% 49 $362.56
83735 <1% 62 $347.60
85610 <1% 672 $330.53
93290 <1% 12 $305.53
J3121 Injection, testosterone enanthate, 1 mg <1% 34 $301.00
73560 <1% 29 $233.21
86308 <1% 599 $169.97
73590 <1% 17 $164.94
86140 <1% 35 $162.05
J1030 Injection, methylprednisolone acetate, 40 mg <1% 14 $139.03
71045 Radiologic examination, chest; single view <1% 12 $136.17
87086 Culture, bacterial; quantitative colony count, urine <1% 19 $135.85
90713 <1% 15 $135.00
73140 <1% 12 $134.16
82951 <1% 13 $133.77
90619 <1% 29 $126.00
90714 <1% 13 $117.56
90649 <1% 13 $117.00
80048 Basic metabolic panel (calcium, ionized) <1% 15 $109.05
1111F <1% 111 $96.84
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 58 $95.30
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 17 $90.92
90694 <1% 77 $75.22
85652 <1% 25 $59.64
G0009 Administration of pneumococcal vaccine <1% 74 $55.07
10060 <1% 13 $42.44
17000 <1% 13 $33.44
93325 <1% 13 $28.28
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 248 $27.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg <1% 12 $19.80
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 16 $13.96
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 388 $11.66
36416 <1% 216 $8.37
36415 Collection of venous blood by venipuncture <1% 225 $8.09
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) <1% 12 $0.96
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen <1% 33 $0.34
1036F 0% 19,016 $0.00
3079F 0% 17,373 $0.00
3080F 0% 3,415 $0.00
3075F 0% 6,936 $0.00
H0049 Alcohol and/or drug screening 0% 3,499 $0.00
87276 0% 16 $0.00
3354F 0% 71 $0.00
A6449 Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard 0% 118 $0.00
1220F 0% 91 $0.00
3078F 0% 29,853 $0.00
3077F 0% 6,144 $0.00
90461 0% 1,764 $0.00
3725F 0% 164 $0.00
4004F 0% 45 $0.00
96160 0% 27 $0.00
99448 0% 47 $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)
Same official

Other billing entities under ANDERSON, DONALD

Full network →
ProviderLocationPaid
Providence Health & Services WashingtonAnchorage, AK$161.45M
Kadlec Regional Medical CenterRichland, WA$151.60M
Swedish EdmondsEdmonds, WA$30.06M
ST. Joseph Health Northern California, LLCEureka, CA$28.68M
Providence Health System Southern CaliforniaTorrance, CA$27.29M
Providence Health System - Southern CaliforniaSan Pedro, CA$24.26M
Providence Health & Services - WashingtonTukwila, WA$21.98M
Swedish Health ServicesSeattle, WA$21.06M
Providence Health & Services WashingtonKodiak, AK$11.39M
Swedish Health ServicesSeattle, WA$11.08M
ST. Joseph Health Northern California, LLCFortuna, CA$8.55M
Collabria CareNapa, CA$8.20M
Providence Health & Services OregonSeaside, OR$8.01M
Providence Health & Services- WashingtonSpokane, WA$8.01M
Hospice of Lubbock INCLubbock, TX$6.48M
Providence Saint John's Health CenterSanta Monica, CA$5.52M
Methodist Hospital LevellandLevelland, TX$4.55M
Collabria CareNapa, CA$4.05M
Methodist Hospital LevellandLevelland, TX$4.01M
Methodist Hospital Plainview TexasPlainview, TX$4.00M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.