Managed care
Clinica MSR. Oscar Romero
Clinica MSR. Oscar Romero was paid $29K by Medicaid between Jan 2018 and Dec 2024, across 92 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoCLINICA MSR. OSCAR ROMERO
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
33aNPI1912156217assigned 09/11/2008
33bProvider typeHealth Maintenance Organization
28Total paid$29K
24GClaims523,867
24DCodes billed92
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Health Maintenance Organization providers in California
Rank by total paid#88 of 151
Median peer was paid$59K
This provider vs. median0.5×
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 | 12,550 | $5K | |
| 2019 | 14,464 | $10K | |
| 2020 | 9,775 | $132.60 | |
| 2021 | 11,188 | $2K | |
| 2022 | 21,682 | $3K | |
| 2023 | 143,168 | $3K | |
| 2024incomplete | 311,040 | $7K |
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 | 35% | 54,932 | 50,868 | $10K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 16% | 34,730 | 31,736 | $5K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 16% | 3,457 | 3,444 | $5K |
| 90686 | 9.6% | 1,908 | 1,905 | $3K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 4.6% | 343 | 336 | $1K |
| 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 | 3.7% | 3,954 | 3,817 | $1K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 3.4% | 608 | 605 | $979.96 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.8% | 5,361 | 5,294 | $809.57 |
| 90658 | 1.9% | 76 | 76 | $541.80 | |
| 82948 | 1.5% | 10,132 | 9,830 | $439.49 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.3% | 383 | 383 | $379.96 |
| 90750 | <1% | 288 | 287 | $200.34 |
80 more codes
| 92551 | <1% | 523 | $187.34 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 165 | $130.23 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 910 | $119.90 |
| 99385 | <1% | 25 | $112.96 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 5,051 | $76.05 |
| 90746 | <1% | 505 | $74.09 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 613 | $59.76 |
| 85018 | <1% | 1,088 | $55.35 | |
| 90837 | Psychotherapy session, about an hour | <1% | 108 | $38.01 |
| 81002 | <1% | 979 | $36.27 | |
| 92002 | <1% | 99 | $32.80 | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 14 | $22.59 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 88 | $8.76 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 207 | $6.92 |
| 81003 | <1% | 1,956 | $5.82 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 1,286 | $0.00 |
| 3078F | 0% | 21,802 | $0.00 | |
| 1160F | 0% | 34,902 | $0.00 | |
| 4040F | 0% | 3,739 | $0.00 | |
| 4274F | 0% | 8,169 | $0.00 | |
| 1159F | 0% | 34,893 | $0.00 | |
| 3051F | 0% | 304 | $0.00 | |
| 59425 | 0% | 172 | $0.00 | |
| 3077F | 0% | 3,468 | $0.00 | |
| 90736 | 0% | 355 | $0.00 | |
| 81025 | 0% | 790 | $0.00 | |
| 99173 | 0% | 558 | $0.00 | |
| 90740 | 0% | 140 | $0.00 | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 0% | 226 | $0.00 |
| 90461 | 0% | 359 | $0.00 | |
| 92015 | Determination of refractive state | 0% | 440 | $0.00 |
| 90715 | 0% | 380 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 26 | $0.00 |
| 2028F | 0% | 129 | $0.00 | |
| 90734 | 0% | 26 | $0.00 | |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 83 | $0.00 |
| 90670 | 0% | 13 | $0.00 | |
| 3046F | 0% | 345 | $0.00 | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 0% | 105 | $0.00 |
| 90661 | 0% | 79 | $0.00 | |
| 90621 | 0% | 14 | $0.00 | |
| 86703 | 0% | 26 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 95 | $0.00 |
| 90633 | 0% | 12 | $0.00 | |
| 2010F | 0% | 33,631 | $0.00 | |
| 1036F | 0% | 40,728 | $0.00 | |
| 92250 | 0% | 347 | $0.00 | |
| 2000F | 0% | 27,188 | $0.00 | |
| 2001F | 0% | 27,498 | $0.00 | |
| 1126F | 0% | 18,355 | $0.00 | |
| 3351F | 0% | 32,105 | $0.00 | |
| 3008F | 0% | 27,434 | $0.00 | |
| 3075F | 0% | 2,907 | $0.00 | |
| 3074F | 0% | 19,064 | $0.00 | |
| 3044F | 0% | 795 | $0.00 | |
| 3079F | 0% | 3,412 | $0.00 | |
| 1170F | 0% | 31,618 | $0.00 | |
| 93000 | 0% | 332 | $0.00 | |
| 1125F | 0% | 3,371 | $0.00 | |
| 3080F | 0% | 523 | $0.00 | |
| 3052F | 0% | 176 | $0.00 | |
| 1034F | 0% | 1,371 | $0.00 | |
| 4010F | 0% | 9,097 | $0.00 | |
| 4037F | 0% | 856 | $0.00 | |
| 90674 | 0% | 213 | $0.00 | |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | 0% | 543 | $0.00 |
| G0467 | Community health center visit, returning patient | 0% | 111 | $0.00 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 0% | 47 | $0.00 |
| 90677 | 0% | 255 | $0.00 | |
| 3352F | 0% | 31 | $0.00 | |
| 0011A | 0% | 106 | $0.00 | |
| 88142 | 0% | 38 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 50 | $0.00 |
| 90651 | 0% | 83 | $0.00 | |
| 99386 | 0% | 26 | $0.00 | |
| 2023F | 0% | 29 | $0.00 | |
| 90732 | 0% | 24 | $0.00 | |
| 90656 | 0% | 23 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 24 | $0.00 |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 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 officialGIBONEY, PAUL (PHYSICIAN)