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SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Health Maintenance Organization·BELLFLOWER, CA·NPI: 1043242555Share

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $52.8M is at the 50th percentile among 10 Health Maintenance Organization providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$52.8M

$52,837,068

Total Claims

2.0M

Beneficiaries

1.9M

1.1 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018
$268K
+191%
2019
$782K
+363%
2020
$3.6M
+103%
2021
$7.3M
+16%
2022
$8.5M
+51%
2023
$12.9M
+50%
2024
$19.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 31% of total spending.

99214Top 25%

Office/outpatient visit, est. patient, mod-high complexity

$16.3M

217K claims · 30.9%

Your Cost: $75.42/claim|Median: $53.41
1.4× median
99284Top 25%

Emergency dept visit, high complexity

$6.9M

69K claims · 13.1%

Your Cost: $99.80/claim|Median: $69.51
1.4× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$4.0M

181K claims · 7.5%

Your Cost: $21.97/claim|Median: $37.81
0.6× median
77067Normal range

Screening mammography, bilateral, including CAD

$1.9M

33K claims · 3.7%

Your Cost: $58.19/claim|Median: $39.33
1.5× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$1.3M

26K claims · 2.4%

Your Cost: $49.42/claim|Median: $38.23
1.3× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$1.2M

9,473 claims · 2.3%

Your Cost: $126.48/claim|Median: $85.65
1.5× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$1.0M

161K claims · 2.0%

Your Cost: $6.44/claim|Median: $9.80
0.7× median
74177Normal range

CT abdomen and pelvis with contrast

$1.0M

9,802 claims · 1.9%

Your Cost: $104.60/claim|Median: $65.76
1.6× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$855K

5,212 claims · 1.6%

Your Cost: $164.11/claim|Median: $54.68
3.0× median
90662Top 5%

$791K

7,051 claims · 1.5%

Your Cost: $112.17/claim|Median: $6.55
17.1× median
99212Normal range

Office/outpatient visit, low complexity

$786K

48K claims · 1.5%

Your Cost: $16.37/claim|Median: $25.06
0.7× median
97110Normal range

Therapeutic exercises, each 15 min

$622K

23K claims · 1.2%

Your Cost: $27.17/claim|Median: $24.49
1.1× median
70450Normal range

CT head/brain without contrast

$617K

11K claims · 1.2%

Your Cost: $56.18/claim|Median: $45.53
1.2× median
88305Normal range

Surgical pathology, gross and microscopic examination

$593K

22K claims · 1.1%

Your Cost: $26.92/claim|Median: $35.80
0.8× median
99283Normal range

Emergency dept visit, moderate complexity

$495K

12K claims · 0.9%

Your Cost: $41.01/claim|Median: $42.48
1.0× median
96413Top 10%

Chemotherapy administration, IV infusion, up to 1 hour

$485K

2,104 claims · 0.9%

Your Cost: $230.32/claim|Median: $75.28
3.1× median
99441Top 25%

Telephone E/M by physician, 5-10 min

$469K

13K claims · 0.9%

Your Cost: $36.06/claim|Median: $13.30
2.7× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$408K

12K claims · 0.8%

Your Cost: $34.82/claim|Median: $57.85
0.6× median
92015Normal range

Determination of refractive state

$401K

45K claims · 0.8%

Your Cost: $9.00/claim|Median: $10.36
0.9× median
96365Normal range

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$390K

4,375 claims · 0.7%

Your Cost: $89.03/claim|Median: $54.77
1.6× median
92002Normal range

Intermediate eye exam, new patient

$305K

9,728 claims · 0.6%

Your Cost: $31.31/claim|Median: $41.61
0.8× median
11721Top 1%

$303K

3,303 claims · 0.6%

Your Cost: $91.70/claim|Median: $8.56
10.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$295K

15K claims · 0.6%

Your Cost: $19.50/claim|Median: $74.82
0.3× median
71045Normal range

Chest X-ray, single view

$285K

49K claims · 0.5%

Your Cost: $5.87/claim|Median: $4.93
1.2× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$271K

6,967 claims · 0.5%

Your Cost: $38.85/claim|Median: $33.72
1.2× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$266K

6,747 claims · 0.5%

Your Cost: $39.46/claim|Median: $36.70
1.1× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$242K

3,504 claims · 0.5%

Your Cost: $69.12/claim|Median: $47.08
1.5× median
71046Normal range

Chest X-ray, 2 views

$230K

21K claims · 0.4%

Your Cost: $10.87/claim|Median: $8.92
1.2× median
92557Top 25%

Comprehensive audiometry, air, bone, and speech testing

$230K

5,401 claims · 0.4%

Your Cost: $42.62/claim|Median: $27.28
1.6× median
99442Top 25%

Telephone E/M by physician, 11-20 minutes

$227K

3,560 claims · 0.4%

Your Cost: $63.82/claim|Median: $22.44
2.8× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$215K

54K claims · 0.4%

Your Cost: $4.00/claim|Median: $7.18
0.6× median
90837Normal range

Psychotherapy, 60 minutes

$206K

5,244 claims · 0.4%

Your Cost: $39.30/claim|Median: $85.66
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$198K

7,791 claims · 0.4%

Your Cost: $25.44/claim|Median: $40.11
0.6× median
99215Normal range

Office/outpatient visit, high complexity

$196K

3,401 claims · 0.4%

Your Cost: $57.49/claim|Median: $74.09
0.8× median
0064ATop 25%

$184K

4,463 claims · 0.3%

Your Cost: $41.25/claim|Median: $34.17
1.2× median
90834Normal range

Psychotherapy, 45 minutes

$181K

9,521 claims · 0.3%

Your Cost: $19.02/claim|Median: $63.65
0.3× median
99392Normal range

Preventive medicine, established patient, age 1-4

$160K

13K claims · 0.3%

Your Cost: $12.15/claim|Median: $75.18
0.2× median
95806Top 25%

$157K

1,297 claims · 0.3%

Your Cost: $121.14/claim|Median: $64.51
1.9× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$157K

4,117 claims · 0.3%

Your Cost: $38.11/claim|Median: $33.85
1.1× median
73562Normal range

$157K

8,714 claims · 0.3%

Your Cost: $18.00/claim|Median: $12.28
1.5× median
0011ATop 25%

COVID-19 vaccine admin, Moderna, 1st dose

$155K

4,217 claims · 0.3%

Your Cost: $36.73/claim|Median: $25.93
1.4× median
77080Normal range

Dual-energy x-ray absorptiometry (DEXA) bone density scan

$152K

5,440 claims · 0.3%

Your Cost: $27.87/claim|Median: $18.93
1.5× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$147K

2,867 claims · 0.3%

Your Cost: $51.12/claim|Median: $84.03
0.6× median
92551Normal range

Screening audiometry, pure tone, air only

$143K

52K claims · 0.3%

Your Cost: $2.74/claim|Median: $6.61
0.4× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$140K

18K claims · 0.3%

Your Cost: $7.87/claim|Median: $4.71
1.7× median
90674Normal range

$137K

12K claims · 0.3%

Your Cost: $11.69/claim|Median: $15.16
0.8× median
76705Normal range

Ultrasound, abdominal, limited

$135K

5,691 claims · 0.3%

Your Cost: $23.65/claim|Median: $23.81
1.0× median
20610Top 10%

Arthrocentesis, aspiration/injection, major joint

$130K

1,132 claims · 0.2%

Your Cost: $114.41/claim|Median: $29.03
3.9× median
67028Top 10%

Intravitreal injection of a pharmacologic agent

$129K

545 claims · 0.2%

Your Cost: $235.93/claim|Median: $58.82
4.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$120K

7,354 claims · 0.2%

Your Cost: $16.32/claim|Median: $69.35
0.2× median

Other Top Providers in California

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Los Angeles County Department of Mental Health

Clinic/Center, Mental Health (Including Community

$6.78B

County of Santa Clara

Community/Behavioral Health

$1.73B

County of Riverside

Community/Behavioral Health

$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

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