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PROVIDENCE MEDICAL FOUNDATION

Family Medicine·BREA, CA·NPI: 1871607762Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $52.6M is at the 75th percentile among 19 Family Medicine providers.

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

Total Paid

$52.6M

$52,585,238

Total Claims

1.6M

Beneficiaries

1.4M

1.1 claims/patient

Avg Cost/Claim

$32

Monthly Spending Trend

Yearly Spending

2018
$4.4M
+41%
2019
$6.1M
-1%
2020
$6.1M
+17%
2021
$7.1M
+18%
2022
$8.4M
+17%
2023
$9.9M
+8%
2024
$10.6M

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 14% of total spending.

99214Normal range

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

$7.2M

250K claims · 13.8%

Your Cost: $28.96/claim|Median: $53.41
0.5× median
99213Normal range

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

$4.8M

243K claims · 9.2%

Your Cost: $19.98/claim|Median: $37.81
0.5× median
99284Normal range

Emergency dept visit, high complexity

$3.1M

38K claims · 5.9%

Your Cost: $81.51/claim|Median: $69.51
1.2× median
H1001Top 25%

$2.9M

32K claims · 5.5%

Your Cost: $91.35/claim|Median: $60.48
1.5× median
99291Normal range

Critical care, first 30-74 minutes

$2.8M

25K claims · 5.4%

Your Cost: $114.71/claim|Median: $101.24
1.1× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$2.8M

82K claims · 5.3%

Your Cost: $33.73/claim|Median: $23.99
1.4× median
99233Normal range

Subsequent hospital care, per day, high complexity

$2.6M

62K claims · 5.0%

Your Cost: $42.16/claim|Median: $35.30
1.2× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$2.5M

31K claims · 4.7%

Your Cost: $78.32/claim|Median: $54.68
1.4× median
99203Normal range

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

$1.5M

28K claims · 2.9%

Your Cost: $54.98/claim|Median: $57.85
1.0× median
S9083Normal range

Global fee, urgent care centers

$1.5M

28K claims · 2.9%

Your Cost: $54.01/claim|Median: $103.99
0.5× median
99283Normal range

Emergency dept visit, moderate complexity

$1.4M

27K claims · 2.7%

Your Cost: $52.90/claim|Median: $42.48
1.2× median
99204Normal range

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

$1.2M

16K claims · 2.4%

Your Cost: $78.86/claim|Median: $84.03
0.9× median
93010Top 5%

Electrocardiogram, interpretation and report only

$1.2M

92K claims · 2.3%

Your Cost: $12.89/claim|Median: $5.60
2.3× median
96156Top 25%

$1.1M

13K claims · 2.0%

Your Cost: $84.08/claim|Median: $22.36
3.8× median
99215Normal range

Office/outpatient visit, high complexity

$1.1M

19K claims · 2.0%

Your Cost: $54.69/claim|Median: $74.09
0.7× median
99223Normal range

Initial hospital care, per day, high complexity

$1.0M

15K claims · 1.9%

Your Cost: $70.14/claim|Median: $67.32
1.0× median
59425Normal range

Antepartum care only, 4-6 visits

$852K

10K claims · 1.6%

Your Cost: $82.73/claim|Median: $63.63
1.3× median
99392Normal range

Preventive medicine, established patient, age 1-4

$606K

17K claims · 1.2%

Your Cost: $36.33/claim|Median: $75.18
0.5× median
99222Normal range

Initial hospital care, per day, moderate complexity

$600K

9,233 claims · 1.1%

Your Cost: $65.04/claim|Median: $51.25
1.3× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$556K

802 claims · 1.1%

Your Cost: $693.47/claim|Median: $470.36
1.5× median
95144Top 5%

$523K

703 claims · 1.0%

Your Cost: $744.16/claim|Median: $109.74
6.8× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$453K

11K claims · 0.9%

Your Cost: $40.53/claim|Median: $43.85
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$422K

10K claims · 0.8%

Your Cost: $40.50/claim|Median: $74.82
0.5× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$404K

9,565 claims · 0.8%

Your Cost: $42.25/claim|Median: $69.35
0.6× median
43239Normal range

Upper GI endoscopy with biopsy

$395K

1,541 claims · 0.8%

Your Cost: $256.03/claim|Median: $151.68
1.7× median
77067Top 5%

Screening mammography, bilateral, including CAD

$388K

2,841 claims · 0.7%

Your Cost: $136.62/claim|Median: $39.33
3.5× median
99282Normal range

Emergency dept visit, low complexity

$371K

12K claims · 0.7%

Your Cost: $32.22/claim|Median: $37.72
0.9× median
99394Normal range

Preventive medicine, established patient, age 12-17

$369K

7,418 claims · 0.7%

Your Cost: $49.70/claim|Median: $80.15
0.6× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$361K

16K claims · 0.7%

Your Cost: $22.30/claim|Median: $39.70
0.6× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$348K

3,317 claims · 0.7%

Your Cost: $104.93/claim|Median: $111.09
0.9× median
99285Normal range

Emergency dept visit, high/urgent complexity

$277K

2,441 claims · 0.5%

Your Cost: $113.40/claim|Median: $85.65
1.3× median
93000Top 5%

Electrocardiogram, complete, with interpretation and report

$273K

11K claims · 0.5%

Your Cost: $24.06/claim|Median: $9.70
2.5× median
96110Top 5%

Developmental screening, per standardized instrument

$258K

4,217 claims · 0.5%

Your Cost: $61.26/claim|Median: $9.10
6.7× median
Z1034Normal range

$258K

4,747 claims · 0.5%

Your Cost: $54.30/claim|Median: $54.74
1.0× median
78452Normal range

Myocardial perfusion imaging, SPECT, multiple studies

$238K

1,865 claims · 0.5%

Your Cost: $127.71/claim|Median: $106.14
1.2× median
45385Top 25%

Colonoscopy with polyp removal, snare technique

$191K

398 claims · 0.4%

Your Cost: $479.38/claim|Median: $255.17
1.9× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$180K

1,279 claims · 0.3%

Your Cost: $140.73/claim|Median: $121.58
1.2× median
95811Normal range

Sleep study with CPAP titration, polysomnography

$179K

746 claims · 0.3%

Your Cost: $239.29/claim|Median: $255.03
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$177K

12K claims · 0.3%

Your Cost: $14.20/claim|Median: $25.06
0.6× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$165K

5,125 claims · 0.3%

Your Cost: $32.26/claim|Median: $40.11
0.8× median
99243Top 25%

Office or other outpatient consultation, low complexity

$155K

1,429 claims · 0.3%

Your Cost: $108.74/claim|Median: $82.43
1.3× median
76815Top 25%

Ultrasound, pregnant uterus, limited

$145K

2,105 claims · 0.3%

Your Cost: $68.66/claim|Median: $36.79
1.9× median
59409Normal range

Vaginal delivery only

$137K

194 claims · 0.3%

Your Cost: $707.84/claim|Median: $619.91
1.1× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$135K

3,744 claims · 0.3%

Your Cost: $36.05/claim|Median: $37.22
1.0× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$126K

14K claims · 0.2%

Your Cost: $8.90/claim|Median: $7.18
1.2× median
G9920Normal range

$122K

9,300 claims · 0.2%

Your Cost: $13.10/claim|Median: $6.56
2.0× median
H1000Top 5%

Prenatal care, at-risk assessment

$116K

695 claims · 0.2%

Your Cost: $166.60/claim|Median: $50.36
3.3× median
59430Normal range

$112K

1,274 claims · 0.2%

Your Cost: $88.11/claim|Median: $80.32
1.1× median
90960Top 25%

End-stage renal disease services, per month, age 20+

$107K

973 claims · 0.2%

Your Cost: $110.40/claim|Median: $52.76
2.1× median
92551Top 25%

Screening audiometry, pure tone, air only

$101K

8,938 claims · 0.2%

Your Cost: $11.28/claim|Median: $6.61
1.7× 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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