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SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Health Maintenance Organization·LOS ANGELES, CA·NPI: 1043242563Share

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $29.7M is at the 25th percentile among 10 Health Maintenance Organization providers.

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

Total Paid

$29.7M

$29,703,566

Total Claims

886K

Beneficiaries

831K

1.1 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$251K
+137%
2019
$594K
+258%
2020
$2.1M
+89%
2021
$4.0M
+10%
2022
$4.4M
+68%
2023
$7.5M
+44%
2024
$10.8M

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 21% of total spending.

99214Normal range

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

$6.2M

91K claims · 20.9%

Your Cost: $68.51/claim|Median: $53.41
1.3× median
99284Normal range

Emergency dept visit, high complexity

$4.8M

53K claims · 16.3%

Your Cost: $91.30/claim|Median: $69.51
1.3× median
92012Top 25%

Ophthalmological exam, intermediate, established patient

$1.2M

22K claims · 4.2%

Your Cost: $56.17/claim|Median: $38.23
1.5× median
91320Top 5%

$1.0M

6,243 claims · 3.5%

Your Cost: $164.99/claim|Median: $72.65
2.3× median
99213Normal range

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

$1.0M

74K claims · 3.5%

Your Cost: $13.85/claim|Median: $37.81
0.4× median
99285Normal range

Emergency dept visit, high/urgent complexity

$1.0M

9,500 claims · 3.4%

Your Cost: $106.79/claim|Median: $85.65
1.2× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$1.0M

5,659 claims · 3.4%

Your Cost: $176.94/claim|Median: $54.68
3.2× median
77067Normal range

Screening mammography, bilateral, including CAD

$988K

20K claims · 3.3%

Your Cost: $50.07/claim|Median: $39.33
1.3× median
99283Normal range

Emergency dept visit, moderate complexity

$793K

19K claims · 2.7%

Your Cost: $40.94/claim|Median: $42.48
1.0× median
96413Top 10%

Chemotherapy administration, IV infusion, up to 1 hour

$545K

2,555 claims · 1.8%

Your Cost: $213.33/claim|Median: $75.28
2.8× median
90471Normal range

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

$528K

74K claims · 1.8%

Your Cost: $7.14/claim|Median: $9.80
0.7× median
88305Normal range

Surgical pathology, gross and microscopic examination

$504K

20K claims · 1.7%

Your Cost: $24.68/claim|Median: $35.80
0.7× median
Q5103Normal range

$465K

465 claims · 1.6%

Your Cost: $1,000.64/claim|Median: $1,075.28
0.9× median
67028Top 25%

Intravitreal injection of a pharmacologic agent

$433K

2,190 claims · 1.5%

Your Cost: $197.57/claim|Median: $58.82
3.4× median
97110Normal range

Therapeutic exercises, each 15 min

$406K

14K claims · 1.4%

Your Cost: $29.55/claim|Median: $24.49
1.2× median
90480Top 5%

$401K

7,932 claims · 1.4%

Your Cost: $50.58/claim|Median: $25.29
2.0× median
90662Top 5%

$400K

3,674 claims · 1.3%

Your Cost: $108.75/claim|Median: $6.55
16.6× median
74177Normal range

CT abdomen and pelvis with contrast

$394K

4,353 claims · 1.3%

Your Cost: $90.46/claim|Median: $65.76
1.4× median
99212Normal range

Office/outpatient visit, low complexity

$371K

25K claims · 1.2%

Your Cost: $14.96/claim|Median: $25.06
0.6× median
96365Normal range

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

$359K

4,383 claims · 1.2%

Your Cost: $81.95/claim|Median: $54.77
1.5× median
70450Normal range

CT head/brain without contrast

$325K

6,807 claims · 1.1%

Your Cost: $47.81/claim|Median: $45.53
1.1× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$259K

2,913 claims · 0.9%

Your Cost: $89.06/claim|Median: $47.08
1.9× median
77080Normal range

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

$238K

7,858 claims · 0.8%

Your Cost: $30.34/claim|Median: $18.93
1.6× median
45378Normal range

Colonoscopy, diagnostic

$209K

593 claims · 0.7%

Your Cost: $352.44/claim|Median: $225.49
1.6× median
Q5123Top 1%

$208K

89 claims · 0.7%

Your Cost: $2,334.90/claim|Median: $1,518.93
1.5× median
11721Top 1%

$202K

1,874 claims · 0.7%

Your Cost: $107.53/claim|Median: $8.56
12.6× median
71045Normal range

Chest X-ray, single view

$193K

35K claims · 0.6%

Your Cost: $5.47/claim|Median: $4.93
1.1× median
99442Top 10%

Telephone E/M by physician, 11-20 minutes

$172K

2,438 claims · 0.6%

Your Cost: $70.44/claim|Median: $22.44
3.1× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$162K

4,198 claims · 0.5%

Your Cost: $38.59/claim|Median: $33.72
1.1× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$158K

4,067 claims · 0.5%

Your Cost: $38.91/claim|Median: $36.70
1.1× median
92002Normal range

Intermediate eye exam, new patient

$153K

4,422 claims · 0.5%

Your Cost: $34.65/claim|Median: $41.61
0.8× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$151K

30K claims · 0.5%

Your Cost: $5.12/claim|Median: $7.18
0.7× median
20610Top 10%

Arthrocentesis, aspiration/injection, major joint

$144K

1,255 claims · 0.5%

Your Cost: $114.89/claim|Median: $29.03
4.0× median
0064ATop 25%

$124K

3,014 claims · 0.4%

Your Cost: $41.05/claim|Median: $34.17
1.2× median
90834Normal range

Psychotherapy, 45 minutes

$123K

7,392 claims · 0.4%

Your Cost: $16.71/claim|Median: $63.65
0.3× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$117K

4,298 claims · 0.4%

Your Cost: $27.29/claim|Median: $40.11
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$112K

6,338 claims · 0.4%

Your Cost: $17.69/claim|Median: $74.82
0.2× median
71046Normal range

Chest X-ray, 2 views

$108K

13K claims · 0.4%

Your Cost: $8.07/claim|Median: $8.92
0.9× median
99441Top 25%

Telephone E/M by physician, 5-10 min

$105K

2,753 claims · 0.4%

Your Cost: $38.03/claim|Median: $13.30
2.9× median
96366Normal range

IV infusion, therapeutic/prophylactic/diagnostic, each additional hour

$98K

2,198 claims · 0.3%

Your Cost: $44.63/claim|Median: $40.12
1.1× median
99223Normal range

Initial hospital care, per day, high complexity

$93K

1,052 claims · 0.3%

Your Cost: $88.83/claim|Median: $67.32
1.3× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$90K

2,412 claims · 0.3%

Your Cost: $37.48/claim|Median: $33.85
1.1× median
0124ANormal range

$89K

2,560 claims · 0.3%

Your Cost: $34.77/claim|Median: $34.32
1.0× median
92134Top 25%

$85K

3,251 claims · 0.3%

Your Cost: $26.06/claim|Median: $15.46
1.7× median
93010Top 25%

Electrocardiogram, interpretation and report only

$83K

8,874 claims · 0.3%

Your Cost: $9.31/claim|Median: $5.60
1.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$82K

6,363 claims · 0.3%

Your Cost: $12.81/claim|Median: $75.18
0.2× median
0011ATop 25%

COVID-19 vaccine admin, Moderna, 1st dose

$80K

2,209 claims · 0.3%

Your Cost: $36.15/claim|Median: $25.93
1.4× median
69210Top 5%

$79K

1,028 claims · 0.3%

Your Cost: $76.44/claim|Median: $21.74
3.5× median
99443Top 25%

Telephone E/M by physician, 21-30 min

$76K

830 claims · 0.3%

Your Cost: $91.06/claim|Median: $32.55
2.8× median
73562Normal range

$74K

4,180 claims · 0.2%

Your Cost: $17.67/claim|Median: $12.28
1.4× median

Other Top Providers in California

View all →

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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