PORTOLA MEDICAL SERVICES PC
NPI: 1871962076
· LAKE FOREST, CA 92630
· Urgent Care Clinic/Center
· NPI assigned 09/17/2015
$1.43M
Total Medicaid Paid
Provider Details
| Authorized Official | ZELLER, MATTHEW (CEO) |
| NPI Enumeration Date | 09/17/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
15 |
$695.20 |
| 2020 |
12 |
$43.52 |
| 2021 |
243 |
$8K |
| 2022 |
2,531 |
$91K |
| 2023 |
14,824 |
$593K |
| 2024 |
13,775 |
$738K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
7,417 |
6,771 |
$450K |
| 99213 |
|
7,135 |
6,491 |
$412K |
| 99204 |
|
4,221 |
4,142 |
$269K |
| 99203 |
|
3,850 |
3,788 |
$216K |
| 87426 |
|
1,560 |
1,504 |
$32K |
| 99070 |
|
1,741 |
1,578 |
$22K |
| 71046 |
|
455 |
440 |
$10K |
| 87804 |
|
1,135 |
565 |
$6K |
| 99212 |
|
56 |
54 |
$2K |
| 73630 |
|
99 |
96 |
$2K |
| 99051 |
|
1,713 |
1,649 |
$2K |
| 96372 |
|
370 |
309 |
$2K |
| 73610 |
|
73 |
71 |
$2K |
| 87880 |
|
551 |
547 |
$1K |
| 81002 |
|
639 |
610 |
$729.24 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
138 |
135 |
$698.66 |
| 94640 |
|
46 |
45 |
$423.10 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
62 |
59 |
$331.89 |
| 87807 |
|
16 |
16 |
$137.12 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
99 |
96 |
$97.80 |
| 93000 |
|
12 |
12 |
$57.40 |
| 99000 |
|
12 |
12 |
$43.52 |