Prohealth Partners a Medical Group
Prohealth Partners a Medical Group was paid $446K by Medicaid between May 2018 and Oct 2024, across 7 billing codes. Its largest line is 90960, End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits — 58% of everything it billed.
LOS ALAMITOS, CA 90720
Next to other Nephrology Physician providers in California
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 99 | $2K | |
| 2020 | 559 | $16K | |
| 2021 | 157 | $7K | |
| 2022 | 983 | $71K | |
| 2023 | 1,761 | $175K | |
| 2024incomplete | 2,869 | $175K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 58% | 1,292 | 1,292 | $259K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 18% | 3,253 | 707 | $82K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 11% | 1,190 | 383 | $50K |
| 90961 | 6.4% | 125 | 125 | $29K | |
| 99223 | Prolong inpt eval add15 m | 3.5% | 186 | 180 | $16K |
| 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 | 2.6% | 370 | 360 | $11K |
| 36415 | Collection of venous blood by venipuncture | 0% | 12 | 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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.