Clinic
Kelley Park Medical Clinic, INC
Kelley Park Medical Clinic, INC was paid $168K by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is 92081, — 23% of everything it billed.
33Billing provider infoKELLEY PARK MEDICAL CLINIC, INC
SAN JOSE, CA 95122
SAN JOSE, CA 95122
33aNPI1942340625assigned 02/08/2007
33bProvider typePrimary Care Clinic/Center
28Total paid$168K
24GClaims12,789
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in California
Rank by total paid#125 of 422
Median peer was paid$25K
This provider vs. median6.8×
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 | 2,803 | $39K | |
| 2019 | 2,206 | $35K | |
| 2020 | 1,648 | $23K | |
| 2021 | 1,797 | $31K | |
| 2022 | 1,543 | $14K | |
| 2023 | 1,631 | $15K | |
| 2024incomplete | 1,161 | $11K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92081 | 23% | 1,151 | 1,110 | $39K | |
| 90686 | 21% | 1,746 | 1,642 | $35K | |
| 92552 | 8.3% | 776 | 775 | $14K | |
| 90682 | 7.9% | 197 | 197 | $13K | |
| 90750 | 7.8% | 77 | 77 | $13K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.7% | 163 | 163 | $8K |
| 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 | 4.7% | 2,133 | 2,107 | $8K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 4.1% | 103 | 63 | $7K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.4% | 97 | 95 | $6K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.6% | 4,781 | 4,589 | $4K |
| 90688 | 2.4% | 245 | 245 | $4K | |
| 90658 | 2.3% | 195 | 195 | $4K |
16 more codes
| 83036 | Hemoglobin; glycosylated (A1C) | 2.2% | 398 | $4K |
| 90656 | 1.4% | 105 | $2K | |
| 90662 | 1.1% | 62 | $2K | |
| 90756 | <1% | 47 | $1K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 27 | $1K |
| 90673 | <1% | 16 | $795.04 | |
| 90657 | <1% | 39 | $450.45 | |
| 90655 | <1% | 14 | $427.14 | |
| 86580 | <1% | 27 | $88.80 | |
| G0008 | Administration of influenza virus vaccine | <1% | 17 | $34.69 |
| 3074F | 0% | 12 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 132 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 129 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 76 | $0.00 |
| 69210 | 0% | 12 | $0.00 | |
| 3078F | 0% | 12 | $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 officialNGUYEN, PETER (DR)
| Provider | Location | Paid |
|---|---|---|
| Holiness Home Healthcare Corp | Katy, TX | $17.60M |
| Manuel Nguyen Pediatric Dentistry | Henderson, NV | $856K |
| Thomas Nguyen Dental Corp | Whittier, CA | $131K |
| Peter P Nguyen DMD INC | Corona, CA | $22K |
| Almar Vista INC | Gardena, CA | $12K |
| Houston Kidney Consultants PLLC | Houston, TX | $8K |
| Tuscano Dental | Phoenix, AZ | $1K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.