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SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Health Maintenance Organization·BALDWIN PARK, CA·NPI: 1770515280Share

Compared to Health Maintenance Organization Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $27.5M is at the 25th percentile among 10 Health Maintenance Organization providers.

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

Total Paid

$27.5M

$27,513,757

Total Claims

1.0M

Beneficiaries

1.0M

1.0 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018
$243K
+115%
2019
$524K
+290%
2020
$2.0M
+86%
2021
$3.8M
+21%
2022
$4.6M
+47%
2023
$6.8M
+41%
2024
$9.5M

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 27% of total spending.

99214Top 25%

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

$7.3M

92K claims · 26.7%

Your Cost: $80.28/claim|Median: $53.41
1.5× median
99284Normal range

Emergency dept visit, high complexity

$3.2M

35K claims · 11.8%

Your Cost: $92.05/claim|Median: $69.51
1.3× median
99213Normal range

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

$1.6M

105K claims · 5.7%

Your Cost: $14.94/claim|Median: $37.81
0.4× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$1.1M

23K claims · 3.9%

Your Cost: $46.73/claim|Median: $38.23
1.2× median
92227Normal range

$877K

83K claims · 3.2%

Your Cost: $10.55/claim|Median: $7.85
1.3× median
99283Normal range

Emergency dept visit, moderate complexity

$852K

20K claims · 3.1%

Your Cost: $42.88/claim|Median: $42.48
1.0× median
77067Normal range

Screening mammography, bilateral, including CAD

$808K

17K claims · 2.9%

Your Cost: $46.76/claim|Median: $39.33
1.2× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$756K

4,552 claims · 2.7%

Your Cost: $165.98/claim|Median: $54.68
3.0× median
90471Normal range

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

$644K

103K claims · 2.3%

Your Cost: $6.23/claim|Median: $9.80
0.6× median
90662Top 5%

$603K

5,579 claims · 2.2%

Your Cost: $108.17/claim|Median: $6.55
16.5× median
67028Top 10%

Intravitreal injection of a pharmacologic agent

$490K

2,345 claims · 1.8%

Your Cost: $208.93/claim|Median: $58.82
3.6× median
88305Normal range

Surgical pathology, gross and microscopic examination

$438K

16K claims · 1.6%

Your Cost: $28.06/claim|Median: $35.80
0.8× median
99285Normal range

Emergency dept visit, high/urgent complexity

$429K

3,472 claims · 1.6%

Your Cost: $123.68/claim|Median: $85.65
1.4× median
70450Normal range

CT head/brain without contrast

$385K

6,748 claims · 1.4%

Your Cost: $57.06/claim|Median: $45.53
1.3× median
93010Top 25%

Electrocardiogram, interpretation and report only

$354K

42K claims · 1.3%

Your Cost: $8.53/claim|Median: $5.60
1.5× median
99212Normal range

Office/outpatient visit, low complexity

$307K

20K claims · 1.1%

Your Cost: $15.55/claim|Median: $25.06
0.6× median
92015Normal range

Determination of refractive state

$289K

34K claims · 1.0%

Your Cost: $8.48/claim|Median: $10.36
0.8× median
92002Normal range

Intermediate eye exam, new patient

$267K

7,753 claims · 1.0%

Your Cost: $34.47/claim|Median: $41.61
0.8× median
74177Normal range

CT abdomen and pelvis with contrast

$265K

3,158 claims · 1.0%

Your Cost: $83.89/claim|Median: $65.76
1.3× median
99442Top 10%

Telephone E/M by physician, 11-20 minutes

$234K

3,276 claims · 0.9%

Your Cost: $71.51/claim|Median: $22.44
3.2× median
97597Top 5%

$232K

1,841 claims · 0.8%

Your Cost: $125.86/claim|Median: $21.22
5.9× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$227K

3,014 claims · 0.8%

Your Cost: $75.26/claim|Median: $47.08
1.6× median
96365Normal range

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

$223K

3,007 claims · 0.8%

Your Cost: $74.07/claim|Median: $54.77
1.4× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$218K

5,656 claims · 0.8%

Your Cost: $38.46/claim|Median: $36.70
1.0× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$211K

5,561 claims · 0.8%

Your Cost: $38.03/claim|Median: $33.72
1.1× median
90834Normal range

Psychotherapy, 45 minutes

$202K

7,096 claims · 0.7%

Your Cost: $28.51/claim|Median: $63.65
0.4× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$183K

44K claims · 0.7%

Your Cost: $4.15/claim|Median: $7.18
0.6× median
71046Normal range

Chest X-ray, 2 views

$163K

19K claims · 0.6%

Your Cost: $8.62/claim|Median: $8.92
1.0× median
20610Top 10%

Arthrocentesis, aspiration/injection, major joint

$162K

1,451 claims · 0.6%

Your Cost: $111.64/claim|Median: $29.03
3.8× median
92557Top 25%

Comprehensive audiometry, air, bone, and speech testing

$144K

2,692 claims · 0.5%

Your Cost: $53.64/claim|Median: $27.28
2.0× median
92134Top 25%

$138K

5,967 claims · 0.5%

Your Cost: $23.11/claim|Median: $15.46
1.5× median
99203Normal range

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

$130K

4,693 claims · 0.5%

Your Cost: $27.68/claim|Median: $57.85
0.5× median
74176Normal range

CT abdomen and pelvis without contrast

$128K

1,491 claims · 0.5%

Your Cost: $86.05/claim|Median: $60.19
1.4× median
71045Normal range

Chest X-ray, single view

$127K

19K claims · 0.5%

Your Cost: $6.57/claim|Median: $4.93
1.3× median
99204Normal range

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

$126K

1,483 claims · 0.5%

Your Cost: $84.82/claim|Median: $84.03
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$122K

1,761 claims · 0.4%

Your Cost: $69.27/claim|Median: $74.09
0.9× median
0064ATop 25%

$116K

2,884 claims · 0.4%

Your Cost: $40.32/claim|Median: $34.17
1.2× median
0124ANormal range

$111K

3,286 claims · 0.4%

Your Cost: $33.78/claim|Median: $34.32
1.0× median
99443Top 10%

Telephone E/M by physician, 21-30 min

$111K

1,067 claims · 0.4%

Your Cost: $103.69/claim|Median: $32.55
3.2× median
0004ANormal range

$90K

2,283 claims · 0.3%

Your Cost: $39.45/claim|Median: $35.62
1.1× median
97110Normal range

Therapeutic exercises, each 15 min

$89K

3,241 claims · 0.3%

Your Cost: $27.35/claim|Median: $24.49
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$88K

4,867 claims · 0.3%

Your Cost: $18.04/claim|Median: $74.82
0.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$87K

4,438 claims · 0.3%

Your Cost: $19.53/claim|Median: $69.35
0.3× median
76705Normal range

Ultrasound, abdominal, limited

$85K

3,607 claims · 0.3%

Your Cost: $23.54/claim|Median: $23.81
1.0× median
93880Top 1%

Duplex ultrasound scan of carotid arteries, bilateral

$82K

218 claims · 0.3%

Your Cost: $378.06/claim|Median: $49.03
7.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$81K

7,042 claims · 0.3%

Your Cost: $11.51/claim|Median: $75.18
0.2× median
90674Normal range

$79K

6,352 claims · 0.3%

Your Cost: $12.42/claim|Median: $15.16
0.8× median
77080Normal range

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

$79K

2,508 claims · 0.3%

Your Cost: $31.43/claim|Median: $18.93
1.7× median
92567Top 25%

$79K

4,514 claims · 0.3%

Your Cost: $17.43/claim|Median: $11.50
1.5× median
J7999Top 5%

$77K

1,204 claims · 0.3%

Your Cost: $63.96/claim|Median: $6.94
9.2× 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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