Physician
Jose D Berganza, M.D INC
Jose D Berganza, M.D INC was paid $615K by Medicaid between Jan 2018 and Dec 2024, across 44 billing codes. Its largest line is 99394, Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) — 18% of everything it billed.
33Billing provider infoJOSE D BERGANZA, M.D INC
BALDWIN PARK, CA 91706
BALDWIN PARK, CA 91706
33aNPI1962560896assigned 12/04/2006
33bProvider typeObstetrics & Gynecology Physician
28Total paid$615K
24GClaims96,067
24DCodes billed44
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in California
Rank by total paid#164 of 791
Median peer was paid$67K
This provider vs. median9.2×
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 | 18,496 | $144K | |
| 2019 | 20,779 | $133K | |
| 2020 | 13,175 | $94K | |
| 2021 | 11,861 | $97K | |
| 2022 | 13,191 | $70K | |
| 2023 | 12,064 | $67K | |
| 2024incomplete | 6,501 | $10K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 18% | 3,522 | 3,431 | $112K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 15% | 3,489 | 3,424 | $92K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 13% | 13,096 | 12,309 | $83K |
| 92551 | 8.0% | 7,189 | 7,156 | $49K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.7% | 1,892 | 1,839 | $47K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 7.0% | 9,062 | 8,960 | $43K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.7% | 734 | 728 | $29K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 4.5% | 5,489 | 4,061 | $28K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.2% | 391 | 383 | $26K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.2% | 19,903 | 18,640 | $26K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 4.0% | 987 | 963 | $25K |
| 85018 | 3.0% | 10,439 | 10,279 | $18K |
32 more codes
| Z1034 | 1.6% | 183 | $10K | |
| 81000 | <1% | 4,851 | $5K | |
| 90658 | <1% | 2,525 | $5K | |
| 81002 | <1% | 3,173 | $4K | |
| 90715 | <1% | 440 | $3K | |
| 90651 | <1% | 1,013 | $3K | |
| 99383 | <1% | 38 | $1K | |
| 90723 | <1% | 478 | $1K | |
| 90647 | <1% | 620 | $1K | |
| 90670 | <1% | 595 | $1K | |
| 90680 | <1% | 264 | $1K | |
| 90734 | <1% | 686 | $659.07 | |
| 90633 | <1% | 335 | $382.00 | |
| 90716 | <1% | 260 | $380.00 | |
| 90707 | <1% | 258 | $264.65 | |
| 90700 | <1% | 247 | $257.79 | |
| 88150 | <1% | 14 | $191.39 | |
| 90620 | <1% | 415 | $156.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 841 | $82.11 |
| 90655 | <1% | 75 | $80.00 | |
| 3078F | <1% | 328 | $30.00 | |
| 81003 | <1% | 19 | $19.18 | |
| 90686 | <1% | 33 | $10.00 | |
| 81025 | <1% | 13 | $8.40 | |
| 90713 | 0% | 52 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 52 | $0.00 |
| G0270 | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes | 0% | 808 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 79 | $0.00 |
| 3008F | 0% | 710 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 113 | $0.00 |
| 3074F | 0% | 341 | $0.00 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 15 | $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 officialBERGANZA, JOSE (PRESIDENT)