Physician
Kay, James
Kay, James was paid $357K by Medicaid between Jan 2018 and Aug 2023, across 33 billing codes. Its largest line is 96156, — 36% of everything it billed.
33Billing provider infoKAY, JAMES
LAKE FOREST, CA 92630
LAKE FOREST, CA 92630
33aNPI1962616656assigned 05/10/2007
33bProvider typePediatrics Physician
28Total paid$357K
24GClaims16,859
24DCodes billed33
24AFirst – last monthJan 2018 – Aug 2023
Compared with peers
Next to other Pediatrics Physician providers in California
Rank by total paid#281 of 1,490
Median peer was paid$15K
This provider vs. median24×
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 | 2,436 | $39K | |
| 2019 | 3,806 | $76K | |
| 2020 | 2,407 | $67K | |
| 2021 | 3,191 | $66K | |
| 2022 | 3,999 | $83K | |
| 2023 | 1,020 | $25K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96156 | 36% | 1,738 | 1,721 | $128K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 14% | 2,407 | 1,935 | $50K |
| 97803 | 7.2% | 2,653 | 2,618 | $26K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.7% | 426 | 398 | $24K |
| 92551 | 6.3% | 1,790 | 1,770 | $23K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.0% | 403 | 331 | $21K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.1% | 258 | 234 | $18K |
| 96151 | 4.7% | 870 | 857 | $17K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.0% | 294 | 250 | $14K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.5% | 869 | 762 | $13K |
| G9920 | Screening performed and negative | 2.6% | 912 | 897 | $9K |
| 90658 | 1.3% | 530 | 518 | $5K |
21 more codes
| 85018 | <1% | 814 | $2K | |
| 96150 | <1% | 58 | $1K | |
| 90686 | <1% | 115 | $1K | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 379 | $851.78 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 29 | $785.47 |
| 90670 | <1% | 82 | $720.00 | |
| 90655 | <1% | 81 | $648.00 | |
| 99406 | <1% | 291 | $501.72 | |
| 90651 | <1% | 51 | $432.00 | |
| 87110 | <1% | 24 | $427.96 | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 33 | $296.84 |
| 87070 | <1% | 36 | $277.84 | |
| 90680 | <1% | 27 | $243.00 | |
| 90633 | <1% | 25 | $216.00 | |
| 96127 | <1% | 336 | $194.43 | |
| 90698 | <1% | 17 | $153.00 | |
| 83655 | <1% | 12 | $138.68 | |
| 99173 | <1% | 1,252 | $2.30 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 12 | $0.00 |
| H0049 | Alcohol and/or drug screening | 0% | 23 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 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.