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 1689606196)

Southern California Permanente Medical Group is a health maintenance organization provider located in Fontana, California. This profile covers 0 Medicare and 462 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	9961 Sierra Ave
City	Fontana
State	CA
ZIP	92335
Taxonomy	Health Maintenance Organization
NPI Enumerated	July 7, 2006

Payer Source	Total Paid
Medicaid	$30.4M
Medicare	$0

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

462 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…	239,360	$20	$5.5M
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.	113,600	$50	$5.1M
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…	277,720	$10	$1.4M
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.	11,050	$120	$1.3M
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…	24,180	$30	$652.9K
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.	11,540	$60	$646.4K
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.	27,590	$20	$634.5K
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…	8,310	$70	$582K
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.	13,010	$40	$520.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	249,370	$1	$498.7K

Showing 1–10 of 462

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 — 15 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

462 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	10	20	880	$600	$2.4M
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…	19	110	190	$140	$1.6M
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…	17	20	220	$2,520	$1.3M
J0178	Injection, aflibercept, 1 mg	73	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.	177	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.	232	1,300	510	$100	$943K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	698	750	950	$50	$890K
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.	22	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	265	430	1,140	$90	$769.9K
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,…	14	60	400	$40	$748.5K

Showing 1–10 of 462

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Hospitals	CA	General Acute Care Hospital	$0	$88M
Rodef Dental Corporation	CA	Pediatric Dentistry	$0	$31.1M
Bunthan Dee	CA	Foot & Ankle Surgery Podiatrist	$241.1K	$0
Vouch Lun	CA	Foot & Ankle Surgery Podiatrist	$125.3K	$0
Nancy Lucas	CA	Certified Registered Nurse Anesthetist	$59.9K	$0
Kevin Lay	CA	Anesthesiology Physician	$18.9K	$0
Samuel Ahn	CA	Vascular & Interventional Radiology Physician	$17.8K	$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

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Frequently Asked Questions

References