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.

Providence Medical Foundation (NPI 1871607762)

Providence Medical Foundation is a family medicine physician provider located in Brea, California. This profile covers 0 Medicare and 331 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	Providence Medical Foundation
Address	955 W Imperial Hwy Ste 110
City	Brea
State	CA
ZIP	92821
Taxonomy	Family Medicine Physician
NPI Enumerated	August 18, 2006

Payer Source	Total Paid
Medicaid	$52.6M
Medicare	$0

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

331 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…	249,770	$30	$7.2M
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…	242,540	$20	$4.9M
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.	38,250	$80	$3.1M
H1001	Prenatal care, at-risk enhanced service; antepartum management	31,730	$90	$2.9M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	24,720	$120	$2.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	81,870	$30	$2.8M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	62,150	$40	$2.6M
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…	31,370	$80	$2.4M
99203	The provider sees a new 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 provider…	28,070	$60	$1.5M
S9083	Global fee urgent care centers	27,860	$50	$1.5M

Showing 1–10 of 331

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

Providence Medical Foundation — 19 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

331 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	182	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.	402	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.	139	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	283	430	1,140	$90	$769.9K
G9012	Other specified case management service not elsewhere classified	376	720	1,110	$110	$651.3K
S9083	Global fee urgent care centers	7	140	2,390	$70	$590.2K
93245	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient who wears it for more than seven days, up to 15 days, to help detect abnormal heart rates and…	6	10	70	$2,190	$581.3K
G6015	Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session	23	40	990	$180	$558K
J0897	Injection, denosumab, 1 mg	72	90	160	$830	$415.2K
90960	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…	170	360	880	$130	$408.5K

Showing 1–10 of 331

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Harbinder Brar	CA	Maternal & Fetal Medicine Physician	$0	$31.3M
Adventist Health Delano	CA	General Acute Care Hospital	$0	$22.3M
Thomas Schlesinger	CA	Retina Specialist (Ophthalmology) Physician	$4.3M	$7.9M
Shalini Yalamanchi	CA	Ophthalmology Physician	$4.6M	$7.2M
Stephen Meffert	CA	Retina Specialist (Ophthalmology) Physician	$3.2M	$5.5M
Matthew Powers	CA	Retina Specialist (Ophthalmology) Physician	$3.7M	$4.3M
Rajiv Rathod	CA	Ophthalmology Physician	$4.3M	$670.6K
Inder Singh	CA	Interventional Cardiology Physician	$4.7M	$0
Timothy You	CA	Ophthalmology Physician	$4.5M	$115.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Medical Transport, Inc.	CA	Land Ambulance	$8.6M	$9.1M
Osamamwode Ogbeiwi	CA	Psychiatric/Mental Health Nurse Practitioner	$475.1K	$0
Heather Paul	CA	Family Nurse Practitioner	$367.5K	$0

Providence Medical Foundation — Billing Profile & Reimbursement Data

Sign up for Providence Medical Foundation — Billing Profile & Reimbursement Data policy alerts

Providence Medical Foundation — Billing Profile & Reimbursement Data

Sign up for Providence Medical Foundation — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References