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.

Permanente Medical Group Inc (NPI 1548343510)

Field	Value
Entity Type	Organization
Organization	Permanente Medical Group Inc
Address	7373 West Lane
City	Stockton
State	CA
ZIP	95210
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 23, 2006

Payer Source	Total Paid
Medicaid	$125.8M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused entity: there is no Medicare billing on file and lifetime Medicaid revenue is $125.8M, indicating Medicaid is the primary payer driving the organization’s billed volume and revenue. The absence of Medicare activity suggests a single-payer orientation in the available claims data rather than a balanced Medicare/Medicaid mix.

Revenue is highly concentrated in a small set of evaluation-and-management codes: the top three Medicaid codes 99213, 99285, and 99284 together account for 45.7% of this provider’s total Medicaid revenue, with $15.3M (16.1%), $15.1M (15.8%), and $13.2M (13.8%) reported respectively. This concentration means a large share of Medicaid dollars for this provider comes from office visits and emergency department E/M services.

The code mix points to a combined model of high emergency-department throughput plus substantial outpatient office care: 99285 and 99284 are high- and moderate-level ED E/M codes (109.2K and 223.6K claims respectively) while 99213 is a common established office-visit code (479K claims). Together these patterns suggest the organization operates significant ED services alongside high-volume ambulatory care rather than a narrowly specialized practice.

Competitive standing within California is dominant on many high-volume Medicaid codes: 99213 ranks #10 of 14524 providers in-state (100th percentile; extreme outlier), 99284 ranks #3 of 1395 providers in-state (100th percentile; extreme outlier), and 99285 ranks #14 of 1297 providers in-state (99th percentile; extreme outlier). Multiple other codes also sit at top in-state positions (for example 91320 ranks #1 of 342 and G0008 ranks #1 of 1809), indicating this provider is a major, system-level participant for a broad set of Medicaid services.

Beyond E/M services, the provider bills substantial ancillary and procedural volume across imaging, vaccination, and chronic care management: examples include 77067 at 84.1K claims and $5.2M revenue (5.5%), 74177 at 34.8K claims and $4.2M revenue (4.5%), 91320 at 31.3K claims and $4.5M revenue (4.7%), and 90962 at 9.1K claims and $3.4M revenue (3.6%). The spread of these codes shows the operation delivers a wide breadth of services—screening mammography, CT imaging, mass COVID vaccination, and monthly ESRD management—supporting a diversified Medicaid revenue base beyond just office and ED visits.

Claim volumes demonstrate very large patient throughput across multiple services: examples include 479K claims for 99213, 223.6K claims for 99284, 200.3K claims for 99212, and 240.6K claims for G0008. These high claim counts, paired with top-percentile state rankings on many codes, reflect scale and capacity to serve large Medicaid populations rather than occasional or low-volume participation.

Clinical acuity and service mix include both high-acuity emergency care and chronic disease management: 99285 (high-level ED E/M) produced $15.1M (15.8%) of Medicaid revenue and 90962 (monthly ESRD management) produced $3.4M (3.6%). This combination signals operational capabilities for urgent/emergent care as well as longitudinal management of complex chronic conditions within the Medicaid population.

The provider has an established presence: the NPI was enumerated on 2006-10-23 (~20 years ago), indicating long tenure in the market. Longitudinal presence coupled with dominant state-level volumes on many codes suggests sustained operational scale rather than a recent volume spike.

Medicaid: Complete Services Breakdown

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

607 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	478,970	$30	$15.3M
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.	109,170	$140	$15.1M
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.	223,560	$60	$13.2M
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…	157,220	$40	$5.7M
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…	84,090	$60	$5.2M
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.	31,250	$140	$4.5M
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.	34,800	$120	$4.2M
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	9,090	$380	$3.4M
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.	130,040	$20	$3.1M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	200,340	$10	$2.8M

Showing 1–10 of 607

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

Permanente Medical Group Inc — 25 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

607 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	141	200	3,070	$120	$4.5M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	160	250	2,420	$220	$3.7M
90885	The provider reviews the medical records of the patient pertaining to psychiatric evaluation to help in establishing the diagnosis and treatment plan.	15	30	380	$90	$2M
H0032	Mental health service plan development by non-physician	595	980	1,080	$160	$1.5M
90378	Immunoglobulin is a very complex protein that is produced by certain cells in the body to protect it from various types of infections and produce passive immunity. RSV–IgIM (respiratory syncytial…	7	20	220	$2,520	$1.3M
A0130	Non-emergency transportation: wheelchair van	246	350	8,830	$30	$1.2M
T4541	Incontinence product, disposable underpad, large, each	149	290	2,820	$50	$1.1M
J0178	Injection, aflibercept, 1 mg	78	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.	8	1,570	680	$110	$1.1M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	23	40	1,220	$120	$1M

Showing 1–10 of 607

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Permanente Medical Group Inc	CA	Internal Medicine Physician	$0	$37.9M
Gurpreet Dhugga	CA	Internal Medicine Physician	$33K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Medical Centers Inc	CA	Federally Qualified Health Center (FQHC)	$0	$26.7M
Community Medical Centers Inc	CA	Federally Qualified Health Center (FQHC)	$0	$23.4M
Zeiter Eye Surgical Center, Inc.	CA	Ophthalmologic Surgery Clinic/Center	$3M	$2.1M
Alberto Del Pilar	CA	Family Medicine Physician	$485.4K	$14.9K
Sujeeth Punnam	CA	Cardiovascular Disease Physician	$469.8K	$0
Mallareddy Maddula	CA	Nephrology Physician	$440K	$0
Mahboob Ali	CA	Interventional Cardiology Physician	$392K	$0
Kusum Lata	CA	Cardiovascular Disease Physician	$386.9K	$0
Rami Georgies	CA	Family Medicine Physician	$383.3K	$0
Dennis Delpaine	CA	Allergy & Immunology Physician	$280.4K	$53.2K

Permanente Medical Group Inc — Billing Profile & Reimbursement Data

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Permanente Medical Group Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References