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SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Health Maintenance Organization·SAN DIEGO, CA·NPI: 1225060742Share

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $42.8M is at the 25th percentile among 10 Health Maintenance Organization providers.

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

Total Paid

$42.8M

$42,844,256

Total Claims

1.9M

Beneficiaries

1.8M

1.1 claims/patient

Avg Cost/Claim

$22

Monthly Spending Trend

Yearly Spending

2018
$188K
+163%
2019
$494K
+360%
2020
$2.3M
+130%
2021
$5.2M
+32%
2022
$6.9M
+54%
2023
$10.6M
+61%
2024
$17.1M

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 19% of total spending.

99214Normal range

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

$8.2M

139K claims · 19.0%

Your Cost: $58.71/claim|Median: $53.41
1.1× median
99284Top 25%

Emergency dept visit, high complexity

$3.5M

31K claims · 8.2%

Your Cost: $113.25/claim|Median: $69.51
1.6× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$2.3M

15K claims · 5.4%

Your Cost: $156.87/claim|Median: $85.65
1.8× median
99213Normal range

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

$2.2M

156K claims · 5.1%

Your Cost: $14.05/claim|Median: $37.81
0.4× median
91320Top 5%

$2.1M

14K claims · 4.9%

Your Cost: $146.17/claim|Median: $72.65
2.0× median
77067Normal range

Screening mammography, bilateral, including CAD

$1.8M

42K claims · 4.2%

Your Cost: $43.50/claim|Median: $39.33
1.1× median
74177Normal range

CT abdomen and pelvis with contrast

$1.4M

10K claims · 3.3%

Your Cost: $139.26/claim|Median: $65.76
2.1× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$1.2M

29K claims · 2.9%

Your Cost: $43.00/claim|Median: $38.23
1.1× median
90480Top 10%

$831K

19K claims · 1.9%

Your Cost: $44.67/claim|Median: $25.29
1.8× median
90471Normal range

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

$823K

153K claims · 1.9%

Your Cost: $5.39/claim|Median: $9.80
0.5× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$820K

6,931 claims · 1.9%

Your Cost: $118.30/claim|Median: $54.68
2.2× median
88305Normal range

Surgical pathology, gross and microscopic examination

$682K

31K claims · 1.6%

Your Cost: $21.84/claim|Median: $35.80
0.6× median
90662Top 5%

$517K

5,139 claims · 1.2%

Your Cost: $100.59/claim|Median: $6.55
15.4× median
71046Normal range

Chest X-ray, 2 views

$447K

54K claims · 1.0%

Your Cost: $8.21/claim|Median: $8.92
0.9× median
96365Normal range

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

$375K

4,967 claims · 0.9%

Your Cost: $75.50/claim|Median: $54.77
1.4× median
99212Normal range

Office/outpatient visit, low complexity

$374K

25K claims · 0.9%

Your Cost: $14.75/claim|Median: $25.06
0.6× median
92015Normal range

Determination of refractive state

$363K

47K claims · 0.8%

Your Cost: $7.66/claim|Median: $10.36
0.7× median
70553Normal range

MRI brain without contrast, then with contrast

$363K

2,238 claims · 0.8%

Your Cost: $162.32/claim|Median: $133.68
1.2× median
70450Normal range

CT head/brain without contrast

$357K

6,670 claims · 0.8%

Your Cost: $53.54/claim|Median: $45.53
1.2× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$339K

687 claims · 0.8%

Your Cost: $493.37/claim|Median: $470.36
1.0× median
92002Normal range

Intermediate eye exam, new patient

$310K

9,760 claims · 0.7%

Your Cost: $31.80/claim|Median: $41.61
0.8× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$279K

68K claims · 0.7%

Your Cost: $4.14/claim|Median: $7.18
0.6× median
82565Top 25%

Creatinine blood test

$274K

58K claims · 0.6%

Your Cost: $4.74/claim|Median: $1.94
2.4× median
77080Normal range

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

$272K

8,972 claims · 0.6%

Your Cost: $30.34/claim|Median: $18.93
1.6× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$241K

6,367 claims · 0.6%

Your Cost: $37.89/claim|Median: $36.70
1.0× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$240K

6,475 claims · 0.6%

Your Cost: $37.12/claim|Median: $33.72
1.1× median
0064ATop 25%

$236K

5,751 claims · 0.6%

Your Cost: $41.05/claim|Median: $34.17
1.2× median
73630Normal range

X-ray, foot, complete, minimum 3 views

$234K

25K claims · 0.5%

Your Cost: $9.33/claim|Median: $12.06
0.8× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$231K

2,966 claims · 0.5%

Your Cost: $77.79/claim|Median: $47.08
1.7× median
97110Normal range

Therapeutic exercises, each 15 min

$230K

12K claims · 0.5%

Your Cost: $18.94/claim|Median: $24.49
0.8× median
90834Normal range

Psychotherapy, 45 minutes

$228K

12K claims · 0.5%

Your Cost: $19.17/claim|Median: $63.65
0.3× median
72148Normal range

MRI lumbar spine without contrast

$219K

2,153 claims · 0.5%

Your Cost: $101.49/claim|Median: $101.03
1.0× median
71260Top 25%

CT chest with contrast

$201K

1,041 claims · 0.5%

Your Cost: $192.97/claim|Median: $48.36
4.0× median
76705Normal range

Ultrasound, abdominal, limited

$200K

8,279 claims · 0.5%

Your Cost: $24.13/claim|Median: $23.81
1.0× median
73562Normal range

$199K

14K claims · 0.5%

Your Cost: $13.85/claim|Median: $12.28
1.1× median
83880Top 5%

$195K

3,227 claims · 0.5%

Your Cost: $60.46/claim|Median: $11.81
5.1× median
95800Top 25%

$195K

1,176 claims · 0.5%

Your Cost: $165.67/claim|Median: $86.65
1.9× median
93010Normal range

Electrocardiogram, interpretation and report only

$193K

29K claims · 0.4%

Your Cost: $6.66/claim|Median: $5.60
1.2× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$187K

4,825 claims · 0.4%

Your Cost: $38.72/claim|Median: $33.85
1.1× median
0011ATop 25%

COVID-19 vaccine admin, Moderna, 1st dose

$182K

4,775 claims · 0.4%

Your Cost: $38.11/claim|Median: $25.93
1.5× median
80051Top 25%

Electrolyte panel blood test

$178K

31K claims · 0.4%

Your Cost: $5.73/claim|Median: $1.56
3.7× median
73564Normal range

$177K

8,207 claims · 0.4%

Your Cost: $21.56/claim|Median: $15.00
1.4× median
70551Normal range

MRI brain without contrast

$175K

1,622 claims · 0.4%

Your Cost: $108.00/claim|Median: $85.39
1.3× median
76641Normal range

Ultrasound imaging of one breast, complete

$172K

4,963 claims · 0.4%

Your Cost: $34.66/claim|Median: $49.03
0.7× median
96413Top 10%

Chemotherapy administration, IV infusion, up to 1 hour

$171K

824 claims · 0.4%

Your Cost: $207.65/claim|Median: $75.28
2.8× median
93880Top 5%

Duplex ultrasound scan of carotid arteries, bilateral

$167K

622 claims · 0.4%

Your Cost: $269.08/claim|Median: $49.03
5.5× median
73030Normal range

$165K

12K claims · 0.4%

Your Cost: $13.76/claim|Median: $10.94
1.3× median
73721Normal range

MRI joint of lower extremity without contrast

$162K

2,534 claims · 0.4%

Your Cost: $63.84/claim|Median: $127.34
0.5× median
84460Normal range

$160K

40K claims · 0.4%

Your Cost: $4.01/claim|Median: $2.58
1.6× median
71045Normal range

Chest X-ray, single view

$160K

32K claims · 0.4%

Your Cost: $5.02/claim|Median: $4.93
1.0× 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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