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SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Health Maintenance Organization·HARBOR CITY, CA·NPI: 1598797011Share

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $20.1M is at the 25th percentile among 10 Health Maintenance Organization providers.

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

Total Paid

$20.1M

$20,058,881

Total Claims

764K

Beneficiaries

723K

1.1 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018
$156K
+149%
2019
$388K
+203%
2020
$1.2M
+122%
2021
$2.6M
+18%
2022
$3.1M
+69%
2023
$5.2M
+42%
2024
$7.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 20% of total spending.

99284Normal range

Emergency dept visit, high complexity

$4.1M

48K claims · 20.5%

Your Cost: $85.54/claim|Median: $69.51
1.2× median
99214Normal range

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

$3.9M

62K claims · 19.4%

Your Cost: $63.02/claim|Median: $53.41
1.2× median
77067Normal range

Screening mammography, bilateral, including CAD

$1.2M

24K claims · 6.1%

Your Cost: $52.34/claim|Median: $39.33
1.3× median
99213Normal range

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

$921K

69K claims · 4.6%

Your Cost: $13.29/claim|Median: $37.81
0.4× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$672K

3,968 claims · 3.3%

Your Cost: $169.31/claim|Median: $54.68
3.1× median
99283Normal range

Emergency dept visit, moderate complexity

$669K

17K claims · 3.3%

Your Cost: $38.46/claim|Median: $42.48
0.9× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$580K

8,512 claims · 2.9%

Your Cost: $68.10/claim|Median: $47.08
1.4× median
90471Normal range

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

$485K

74K claims · 2.4%

Your Cost: $6.52/claim|Median: $9.80
0.7× median
88305Normal range

Surgical pathology, gross and microscopic examination

$384K

17K claims · 1.9%

Your Cost: $22.50/claim|Median: $35.80
0.6× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$323K

5,815 claims · 1.6%

Your Cost: $55.61/claim|Median: $59.72
0.9× median
90662Top 5%

$314K

2,853 claims · 1.6%

Your Cost: $109.96/claim|Median: $6.55
16.8× median
97110Normal range

Therapeutic exercises, each 15 min

$282K

11K claims · 1.4%

Your Cost: $26.41/claim|Median: $24.49
1.1× median
92015Normal range

Determination of refractive state

$257K

30K claims · 1.3%

Your Cost: $8.68/claim|Median: $10.36
0.8× median
71046Normal range

Chest X-ray, 2 views

$245K

26K claims · 1.2%

Your Cost: $9.32/claim|Median: $8.92
1.0× median
67028Top 10%

Intravitreal injection of a pharmacologic agent

$243K

1,192 claims · 1.2%

Your Cost: $203.90/claim|Median: $58.82
3.5× median
92012Top 25%

Ophthalmological exam, intermediate, established patient

$241K

4,403 claims · 1.2%

Your Cost: $54.66/claim|Median: $38.23
1.4× median
77080Normal range

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

$215K

6,934 claims · 1.1%

Your Cost: $31.07/claim|Median: $18.93
1.6× median
99212Normal range

Office/outpatient visit, low complexity

$204K

15K claims · 1.0%

Your Cost: $13.20/claim|Median: $25.06
0.5× median
90837Normal range

Psychotherapy, 60 minutes

$192K

4,520 claims · 1.0%

Your Cost: $42.48/claim|Median: $85.66
0.5× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$171K

4,408 claims · 0.9%

Your Cost: $38.76/claim|Median: $36.70
1.1× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$169K

4,363 claims · 0.8%

Your Cost: $38.75/claim|Median: $33.72
1.1× median
73562Normal range

$161K

8,538 claims · 0.8%

Your Cost: $18.89/claim|Median: $12.28
1.5× median
99285Normal range

Emergency dept visit, high/urgent complexity

$155K

1,739 claims · 0.8%

Your Cost: $89.27/claim|Median: $85.65
1.0× median
96413Top 5%

Chemotherapy administration, IV infusion, up to 1 hour

$145K

583 claims · 0.7%

Your Cost: $248.89/claim|Median: $75.28
3.3× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$145K

30K claims · 0.7%

Your Cost: $4.75/claim|Median: $7.18
0.7× median
71045Normal range

Chest X-ray, single view

$124K

22K claims · 0.6%

Your Cost: $5.58/claim|Median: $4.93
1.1× median
74177Normal range

CT abdomen and pelvis with contrast

$120K

1,646 claims · 0.6%

Your Cost: $73.04/claim|Median: $65.76
1.1× median
70450Normal range

CT head/brain without contrast

$117K

2,186 claims · 0.6%

Your Cost: $53.32/claim|Median: $45.53
1.2× median
99203Normal range

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

$102K

2,024 claims · 0.5%

Your Cost: $50.24/claim|Median: $57.85
0.9× median
0064ATop 25%

$102K

2,453 claims · 0.5%

Your Cost: $41.41/claim|Median: $34.17
1.2× median
92134Top 25%

$98K

3,487 claims · 0.5%

Your Cost: $27.98/claim|Median: $15.46
1.8× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$95K

2,515 claims · 0.5%

Your Cost: $37.66/claim|Median: $33.85
1.1× median
90834Normal range

Psychotherapy, 45 minutes

$94K

2,803 claims · 0.5%

Your Cost: $33.37/claim|Median: $63.65
0.5× median
0124ANormal range

$93K

2,693 claims · 0.5%

Your Cost: $34.63/claim|Median: $34.32
1.0× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$87K

2,439 claims · 0.4%

Your Cost: $35.51/claim|Median: $25.93
1.4× median
99441Normal range

Telephone E/M by physician, 5-10 min

$86K

4,837 claims · 0.4%

Your Cost: $17.81/claim|Median: $13.30
1.3× median
73030Normal range

$84K

4,523 claims · 0.4%

Your Cost: $18.54/claim|Median: $10.94
1.7× median
93010Top 25%

Electrocardiogram, interpretation and report only

$83K

9,323 claims · 0.4%

Your Cost: $8.93/claim|Median: $5.60
1.6× median
73630Normal range

X-ray, foot, complete, minimum 3 views

$83K

6,969 claims · 0.4%

Your Cost: $11.87/claim|Median: $12.06
1.0× median
99393Normal range

Preventive medicine, established patient, age 5-11

$82K

4,281 claims · 0.4%

Your Cost: $19.17/claim|Median: $74.82
0.3× median
92557Top 25%

Comprehensive audiometry, air, bone, and speech testing

$80K

1,805 claims · 0.4%

Your Cost: $44.35/claim|Median: $27.28
1.6× median
11721Top 1%

$70K

784 claims · 0.3%

Your Cost: $88.92/claim|Median: $8.56
10.4× median
99204Normal range

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

$68K

839 claims · 0.3%

Your Cost: $80.61/claim|Median: $84.03
1.0× median
99442Top 25%

Telephone E/M by physician, 11-20 minutes

$63K

1,118 claims · 0.3%

Your Cost: $56.64/claim|Median: $22.44
2.5× median
0134ANormal range

$62K

1,684 claims · 0.3%

Your Cost: $36.79/claim|Median: $33.54
1.1× median
92551Normal range

Screening audiometry, pure tone, air only

$60K

21K claims · 0.3%

Your Cost: $2.87/claim|Median: $6.61
0.4× median
91320Top 5%

$59K

296 claims · 0.3%

Your Cost: $199.14/claim|Median: $72.65
2.7× median
72100Normal range

$56K

2,904 claims · 0.3%

Your Cost: $19.43/claim|Median: $15.14
1.3× median
78815Normal range

PET imaging for limited area

$51K

192 claims · 0.3%

Your Cost: $267.41/claim|Median: $325.10
0.8× median
20610Top 10%

Arthrocentesis, aspiration/injection, major joint

$50K

628 claims · 0.2%

Your Cost: $79.36/claim|Median: $29.03
2.7× 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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