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SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Health Maintenance Organization·LOS ANGELES, CA·NPI: 1134151657Share

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $48.2M is at the 25th percentile among 10 Health Maintenance Organization providers.

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

Total Paid

$48.2M

$48,191,352

Total Claims

1.1M

Beneficiaries

1.0M

1.1 claims/patient

Avg Cost/Claim

$44

Monthly Spending Trend

Yearly Spending

2018
$255K
+347%
2019
$1.1M
+206%
2020
$3.5M
+80%
2021
$6.3M
+23%
2022
$7.7M
+52%
2023
$11.7M
+51%
2024
$17.6M

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 18% of total spending.

99214Top 25%

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

$8.8M

94K claims · 18.2%

Your Cost: $93.25/claim|Median: $53.41
1.7× median
99284Top 25%

Emergency dept visit, high complexity

$4.4M

46K claims · 9.1%

Your Cost: $95.68/claim|Median: $69.51
1.4× median
77386Top 25%

Intensity modulated radiation treatment delivery, complex

$3.1M

5,646 claims · 6.4%

Your Cost: $549.27/claim|Median: $260.56
2.1× median
91320Top 5%

$2.1M

12K claims · 4.3%

Your Cost: $168.66/claim|Median: $72.65
2.3× median
99213Normal range

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

$1.9M

77K claims · 4.0%

Your Cost: $25.03/claim|Median: $37.81
0.7× median
78815Top 5%

PET imaging for limited area

$1.7M

1,051 claims · 3.6%

Your Cost: $1,653.37/claim|Median: $325.10
5.1× median
77067Normal range

Screening mammography, bilateral, including CAD

$1.5M

21K claims · 3.1%

Your Cost: $70.55/claim|Median: $39.33
1.8× median
Q5103Normal range

$1.1M

798 claims · 2.4%

Your Cost: $1,425.07/claim|Median: $1,075.28
1.3× median
99283Normal range

Emergency dept visit, moderate complexity

$980K

22K claims · 2.0%

Your Cost: $44.87/claim|Median: $42.48
1.1× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$857K

7,045 claims · 1.8%

Your Cost: $121.69/claim|Median: $54.68
2.2× median
74177Top 25%

CT abdomen and pelvis with contrast

$842K

4,927 claims · 1.7%

Your Cost: $170.97/claim|Median: $65.76
2.6× median
90471Normal range

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

$805K

89K claims · 1.7%

Your Cost: $9.08/claim|Median: $9.80
0.9× median
90480Top 5%

$780K

15K claims · 1.6%

Your Cost: $52.84/claim|Median: $25.29
2.1× median
70450Normal range

CT head/brain without contrast

$729K

14K claims · 1.5%

Your Cost: $50.86/claim|Median: $45.53
1.1× median
90662Top 5%

$648K

5,842 claims · 1.3%

Your Cost: $110.99/claim|Median: $6.55
16.9× median
92012Top 25%

Ophthalmological exam, intermediate, established patient

$648K

10K claims · 1.3%

Your Cost: $62.04/claim|Median: $38.23
1.6× median
99212Normal range

Office/outpatient visit, low complexity

$598K

27K claims · 1.2%

Your Cost: $21.99/claim|Median: $25.06
0.9× median
67028Top 10%

Intravitreal injection of a pharmacologic agent

$594K

2,735 claims · 1.2%

Your Cost: $217.02/claim|Median: $58.82
3.7× median
88305Normal range

Surgical pathology, gross and microscopic examination

$560K

19K claims · 1.2%

Your Cost: $28.98/claim|Median: $35.80
0.8× median
J0178Top 1%

Injection, aflibercept, 1 mg

$527K

181 claims · 1.1%

Your Cost: $2,908.88/claim|Median: $730.09
4.0× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$497K

5,481 claims · 1.0%

Your Cost: $90.68/claim|Median: $47.08
1.9× median
J0585Top 25%

Injection, onabotulinumtoxinA, 1 unit

$475K

638 claims · 1.0%

Your Cost: $745.23/claim|Median: $470.36
1.6× median
99285Normal range

Emergency dept visit, high/urgent complexity

$453K

4,673 claims · 0.9%

Your Cost: $96.87/claim|Median: $85.65
1.1× median
96365Normal range

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

$442K

4,743 claims · 0.9%

Your Cost: $93.28/claim|Median: $54.77
1.7× median
90961Top 1%

$400K

586 claims · 0.8%

Your Cost: $682.92/claim|Median: $47.22
14.5× median
96413Top 10%

Chemotherapy administration, IV infusion, up to 1 hour

$384K

1,557 claims · 0.8%

Your Cost: $246.67/claim|Median: $75.28
3.3× median
77080Normal range

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

$379K

12K claims · 0.8%

Your Cost: $31.88/claim|Median: $18.93
1.7× median
97110Normal range

Therapeutic exercises, each 15 min

$373K

11K claims · 0.8%

Your Cost: $35.09/claim|Median: $24.49
1.4× median
90962Top 1%

$372K

695 claims · 0.8%

Your Cost: $535.31/claim|Median: $40.91
13.1× median
92015Normal range

Determination of refractive state

$309K

28K claims · 0.6%

Your Cost: $11.05/claim|Median: $10.36
1.1× median
71046Normal range

Chest X-ray, 2 views

$292K

24K claims · 0.6%

Your Cost: $12.38/claim|Median: $8.92
1.4× median
99442Top 25%

Telephone E/M by physician, 11-20 minutes

$290K

4,652 claims · 0.6%

Your Cost: $62.24/claim|Median: $22.44
2.8× median
72148Top 25%

MRI lumbar spine without contrast

$254K

1,377 claims · 0.5%

Your Cost: $184.70/claim|Median: $101.03
1.8× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$253K

41K claims · 0.5%

Your Cost: $6.22/claim|Median: $7.18
0.9× median
74176Normal range

CT abdomen and pelvis without contrast

$253K

1,998 claims · 0.5%

Your Cost: $126.40/claim|Median: $60.19
2.1× median
92134Top 25%

$236K

8,366 claims · 0.5%

Your Cost: $28.16/claim|Median: $15.46
1.8× median
70553Normal range

MRI brain without contrast, then with contrast

$233K

1,229 claims · 0.5%

Your Cost: $189.91/claim|Median: $133.68
1.4× median
11721Top 1%

$230K

2,714 claims · 0.5%

Your Cost: $84.88/claim|Median: $8.56
9.9× median
99441Normal range

Telephone E/M by physician, 5-10 min

$216K

8,604 claims · 0.4%

Your Cost: $25.16/claim|Median: $13.30
1.9× median
73562Normal range

$187K

8,364 claims · 0.4%

Your Cost: $22.39/claim|Median: $12.28
1.8× median
71045Normal range

Chest X-ray, single view

$186K

46K claims · 0.4%

Your Cost: $4.03/claim|Median: $4.93
0.8× median
70551Normal range

MRI brain without contrast

$178K

1,557 claims · 0.4%

Your Cost: $114.23/claim|Median: $85.39
1.3× median
0064ATop 25%

$176K

4,308 claims · 0.4%

Your Cost: $40.86/claim|Median: $34.17
1.2× median
78451Top 25%

$171K

444 claims · 0.4%

Your Cost: $384.11/claim|Median: $84.57
4.5× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$170K

4,438 claims · 0.4%

Your Cost: $38.34/claim|Median: $36.70
1.0× median
92557Top 25%

Comprehensive audiometry, air, bone, and speech testing

$169K

3,237 claims · 0.4%

Your Cost: $52.15/claim|Median: $27.28
1.9× median
76705Normal range

Ultrasound, abdominal, limited

$167K

4,313 claims · 0.3%

Your Cost: $38.77/claim|Median: $23.81
1.6× median
73564Top 25%

$162K

4,808 claims · 0.3%

Your Cost: $33.64/claim|Median: $15.00
2.2× median
90834Normal range

Psychotherapy, 45 minutes

$161K

6,911 claims · 0.3%

Your Cost: $23.30/claim|Median: $63.65
0.4× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$159K

4,350 claims · 0.3%

Your Cost: $36.66/claim|Median: $33.72
1.1× 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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