Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. California (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Southern California Permanente Medical Group (NPI 1225060742)

Southern California Permanente Medical Group is a health maintenance organization provider located in San Diego, California. This profile covers 0 Medicare and 380 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Southern California Permanente Medical Group
Address	4647 Zion Ave
City	San Diego
State	CA
ZIP	92120
Taxonomy	Health Maintenance Organization
NPI Enumerated	July 7, 2006

Payer Source	Total Paid
Medicaid	$42.8M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

380 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	138,830	$60	$8.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	31,210	$110	$3.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	14,750	$160	$2.3M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	156,010	$10	$2.2M
91320	This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL.	14,340	$150	$2.1M
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	41,550	$40	$1.8M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	10,080	$140	$1.4M
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	29,000	$40	$1.2M
90480	The provider administers the first or only component of a SARS–CoV–2 (COVID–19) vaccine by intramuscular injection to reduce the patient's risk of contracting COVID–19.	18,600	$50	$837.1K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	6,930	$120	$817.9K

Showing 1–10 of 380

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Southern California Permanente Medical Group — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

380 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	25	110	190	$140	$1.6M
J0178	Injection, aflibercept, 1 mg	100	120	380	$970	$1.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	796	1,570	680	$110	$1.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	206	1,300	510	$100	$943K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	170	1,400	470	$80	$884.5K
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	18	60	400	$40	$748.5K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	154	230	270	$840	$717.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	90	780	1,160	$130	$576.2K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	184	360	840	$160	$495.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	608	660	1,490	$30	$417.2K

Showing 1–10 of 380

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nicholas Bai	CA	Physician Assistant	$6M	$0
Bernard Michlin	CA	Internal Medicine Physician	$1.1M	$363K
Fred Shahan	CA	Dermatology Physician	$1.3M	$0
Oleg Gavrilyuk	CA	Physical Medicine & Rehabilitation Physician	$366.1K	$1K
Scott Leary	CA	Neurological Surgery Physician	$282.4K	$0
Jeannine Shively	CA	Physician Assistant	$250K	$0
James Bates	CA	Orthopaedic Surgery Physician	$155.2K	$0
Herman Skorobogaty	CA	Surgery Physician	$110.4K	$0
Larry Emdur	CA	Pulmonary Disease Physician	$63.7K	$0
William Lo	CA	Anesthesiology Physician	$59.6K	$0

Southern California Permanente Medical Group — Billing Profile & Reimbursement Data

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Southern California Permanente Medical Group — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern California Permanente Medical Group	CA	Clinical Medical Laboratory	$452.8K	$63.4M
Southern California Permanente Medical Group	CA	Health Maintenance Organization	$0	$48.2M
Southern California Permanente Medical Group	CA	Health Maintenance Organization	$0	$35.6M
Southern California Permanente Medical Group	CA	Health Maintenance Organization	$0	$29.7M
Southern California Permanente Medical Group	CA	Health Maintenance Organization	$0	$27.5M