Flores, Edgar
Flores, Edgar was paid $639K by Medicaid between Jan 2018 and Aug 2023, across 50 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoFLORES, EDGAR
FULLERTON, CA 92833
FULLERTON, CA 92833
33aNPI1992857239assigned 01/17/2007
33bProvider typeLegal Medicine
28Total paid$639K
24GClaims60,736
24DCodes billed50
24AFirst – last monthJan 2018 – Aug 2023
Compared with peers
Next to other Legal Medicine providers in California
Rank by total paid#6 of 39
Median peer was paid$17K
This provider vs. median37×
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 | 3,140 | $67K | |
| 2019 | 7,951 | $117K | |
| 2020 | 11,557 | $131K | |
| 2021 | 13,590 | $104K | |
| 2022 | 13,930 | $111K | |
| 2023 | 10,568 | $109K |
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 | 34% | 7,395 | 5,499 | $218K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 14% | 4,379 | 3,297 | $90K |
| 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 | 8.2% | 1,295 | 942 | $52K |
| 96156 | 6.1% | 1,570 | 1,536 | $39K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 3.9% | 1,950 | 1,569 | $25K |
| 92551 | 3.9% | 1,923 | 1,896 | $25K | |
| G9920 | Screening performed and negative | 3.6% | 966 | 935 | $23K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 3.4% | 1,620 | 1,589 | $22K |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 3.0% | 517 | 495 | $19K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 2.8% | 1,370 | 1,310 | $18K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 2.7% | 3,632 | 3,314 | $17K |
| 90682 | 1.9% | 207 | 204 | $12K |
38 more codes
| 99203 | Doctor's office visit, new patient (routine) | 1.6% | 233 | $10K |
| 99406 | 1.5% | 867 | $9K | |
| 99000 | 1.5% | 2,592 | $9K | |
| 99497 | 1.3% | 134 | $8K | |
| 90686 | <1% | 329 | $6K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 50 | $5K |
| 90671 | <1% | 27 | $5K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 869 | $5K |
| 59425 | <1% | 41 | $3K | |
| 96127 | <1% | 2,636 | $3K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 116 | $3K |
| 81000 | <1% | 820 | $2K | |
| 85018 | <1% | 658 | $1K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 52 | $1K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $1K |
| 99205 | Prolong outpt/office vis | <1% | 12 | $1K |
| 99385 | <1% | 27 | $1K | |
| 93000 | <1% | 27 | $950.80 | |
| 90715 | <1% | 25 | $835.83 | |
| 82962 | <1% | 346 | $813.16 | |
| 96151 | <1% | 31 | $588.98 | |
| 97802 | <1% | 433 | $567.52 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 59 | $502.79 |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 81 | $128.03 |
| 81025 | <1% | 41 | $112.00 | |
| 99070 | <1% | 30 | $102.33 | |
| 82948 | <1% | 32 | $88.81 | |
| 3079F | 0% | 1,633 | $0.00 | |
| 3074F | 0% | 5,103 | $0.00 | |
| 3075F | 0% | 1,557 | $0.00 | |
| 3008F | 0% | 9,313 | $0.00 | |
| 1157F | 0% | 124 | $0.00 | |
| 99386 | 0% | 14 | $0.00 | |
| 99173 | 0% | 217 | $0.00 | |
| 3078F | 0% | 5,002 | $0.00 | |
| 99401 | 0% | 341 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 12 | $0.00 |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 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.