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    OpenPayerNPI Medicare & MedicaidSouthern California Permanente Medical Group
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    Southern California Permanente Medical Group — Billing Profile & Reimbursement Data

    NPI 1407888928 · Panorama City, CA · Health Maintenance Organization

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    Southern California Permanente Medical Group is a health maintenance organization provider located in Panorama City, California. This profile covers 0 Medicare and 370 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSouthern California Permanente Medical Group
    Address13652 Cantara St
    CityPanorama City
    StateCA
    ZIP91402
    TaxonomyHealth Maintenance Organization
    NPI EnumeratedJuly 7, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$35.6M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    370 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…116,690$70$8.6M
    99284The 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.44,570$110$4.7M
    99213The 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…144,980$20$2.3M
    91320This 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.7,610$170$1.3M
    92012For 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…24,010$50$1.2M
    99285The 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.7,070$160$1.1M
    77067The 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…21,650$40$931K
    88305The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…29,620$30$740.6K
    93306The 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…4,480$160$712.5K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.96,250$10$577.5K

    Showing 1–10 of 370

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. California median

    370 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    81220The 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…40110190$140$1.6M
    J0178Injection, aflibercept, 1 mg114120380$970$1.1M
    99283The 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.4361,570680$110$1.1M
    99285The 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.2821,300510$100$943K
    99284The 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.1121,400470$80$884.5K
    99281The provider sees a patient for the lowest level emergency department visit.3414301,140$90$769.9K
    81329The 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,…2760400$40$748.5K
    78815PET 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.…139230270$840$717.2K
    74177The 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.2547801,160$130$576.2K
    67028The 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.108360840$160$495.3K

    Showing 1–10 of 370

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Southern California Permanente Medical Group, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Southern California Permanente Medical GroupCAClinical Medical Laboratory$452.8K$63.4M
    Southern California Permanente Medical GroupCAHealth Maintenance Organization$0$48.2M
    Southern California Permanente Medical GroupCAHealth Maintenance Organization$0$42.8M
    Southern California Permanente Medical GroupCAHealth Maintenance Organization$0$29.7M
    Southern California Permanente Medical GroupCAHealth Maintenance Organization$0$27.5M

    Nearby Providers

    Other providers in the same ZIP code as Southern California Permanente Medical Group, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Kaiser Foundation HospitalsCAGeneral Acute Care Hospital$0$75.2M
    Center For Family Health And Education IncCAFederally Qualified Health Center (FQHC)$0$26.6M
    Regents Of The University OfCAClinical Medical Laboratory$8.5M$2.4M
    Firstmed Ambulance Services, Inc.CAAmbulance$3.5M$6.9M
    Hermilito VillarCAInternal Medicine Physician$1.9M$0
    Sirius Imaging IncCADiagnostic Ultrasound Physician$1.4M$119.4K
    Bernadette GuiaCAFamily Nurse Practitioner$556.7K$58.1K
    Reyadh MichailCAFamily Medicine Physician$345.9K$820
    James LauCAUrology Physician$239K$0
    Western Pacific Med-corpCAMethadone Clinic$203.2K$30.9K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. California Providers
    5 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. California Distribution
    Southern California Permanente Medical Group — 15 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California