Medicare Enrolled
Dr. Paul Usborne, M.D.
Family Medicine · Covina, CA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Low-engagement
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Usborne from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Usborne
Dr. Paul Usborne is a family medicine specialist in Covina, CA, with 19 years of NPI registration. Based on federal Medicare data, Dr. Usborne performed 4,112 Medicare services across 2,152 unique beneficiaries.
Between the years covered by Open Payments, Dr. Usborne received a total of $216 from 8 pharmaceutical and/or device companies across 12 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in family medicine. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Usborne is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 19 years in practice
▲ Top 4% volume in CA
$216 industry payments
Medicare Practice Summary
Medicare Utilization ↗4,112
Medicare services
Top 4% in CA for family medicine
2,152
Unique beneficiaries
$62
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~216 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
522 | $103 | $210 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
321 | $71 | $185 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
300 | $53 | $100 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
295 | $96 | $250 |
| Drug injection, under skin or into muscle A procedure involving the administration of a medication or substance via injection into the subcutaneous tissue or muscle. |
286 | $12 | $42 |
| Chronic care management, first 30 minutes This service covers the initial 30 minutes of care coordination for patients with two or more chronic conditions. It is provided personally by a healthcare professional each calendar month. |
224 | $72 | $100 |
| Vitamin B-12 injection An injection of vitamin B-12 (cyanocobalamin) with a dose of up to 1000 mcg. |
214 | $1 | $25 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
172 | $63 | $250 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
171 | $11 | $85 |
| Annual alcohol misuse screening, 5 to 15 minutes | 159 | $21 | $25 |
| Complex chronic care management, first 60 minutes This service involves clinical staff time directed by a healthcare professional to manage two or more chronic conditions over a calendar month. It covers the first 60 minutes of this coordinated care effort. |
151 | $116 | $150 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
133 | $140 | $335 |
| Annual depression screening | 126 | $21 | $40 |
| Ketorolac injection, per 15 mg An injection of ketorolac tromethamine, a nonsteroidal anti-inflammatory drug, administered in doses measured per 15 mg. |
126 | $0 | $20 |
| Telephone medical discussion, 11-20 minutes A phone conversation with a physician lasting between 11 and 20 minutes. |
100 | $73 | $130 |
| Obesity behavioral counseling, 15 minutes A 15-minute face-to-face session focused on behavioral counseling to help manage obesity. |
93 | $27 | $45 |
| Home health agency supervision, complex multidisciplinary care Supervision by a physician or allowed practitioner for a patient receiving Medicare-covered services from a participating home health agency. This involves complex and multidisciplinary care modalities, with the patient not present during the supervision. |
87 | $89 | $135 |
| Quadrivalent influenza vaccine, cell culture-derived A flu shot that protects against four strains of the influenza virus. It is produced using cell culture technology rather than traditional egg-based methods. |
83 | $31 | $45 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
82 | $33 | $38 |
| Additional chronic care management time, 60 minutes This service covers an additional 60 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions, billed per calendar month. |
71 | $61 | $150 |
| Chronic care management, additional 20 min/month This service covers an extra 20 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions each calendar month. |
56 | $41 | $115 |
| Telephone medical discussion, 5-10 minutes A phone conversation with a physician lasting between 5 and 10 minutes to discuss medical matters. |
55 | $45 | $75 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
53 | $143 | $235 |
| Hospital discharge management, 30+ min This service covers the care provided by a physician or qualified healthcare professional on the day a patient is discharged from the hospital. It requires more than 30 minutes of total time spent on the day of discharge. |
44 | $91 | $150 |
| Urinalysis, manual A manual laboratory examination of a urine sample to check for various substances and cells. |
33 | $3 | $9 |
| Smoking cessation counseling, 4-10 minutes A brief counseling session focused on helping patients quit smoking and tobacco use. The provider spends 4 to 10 minutes discussing strategies and support for cessation. |
31 | $16 | $25 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
29 | $132 | $260 |
| Ear wax removal A procedure to remove impacted ear wax from the ear canal. |
28 | $36 | $70 |
| Annual wellness visit, initial visit A yearly appointment to review your health and create a personalized prevention plan. This initial visit focuses on preventive care and health assessment. |
28 | $178 | $385 |
| Telephone medical discussion, 21-30 minutes A telephone conversation with a physician lasting between 21 and 30 minutes. This code covers the time spent discussing medical matters over the phone. |
24 | $105 | $160 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
15 | $226 | $375 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
Industry Payment Transparency
Open Payments through 2023 ↗$216
Total received (2018-2023)
Avg $72/year across 3 years
Bottom 48% in CA for family medicine
8
Companies
12
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$216 (100.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2023
$21
2019
$98
2018
$96
Payments by company (2023)
Consulting
Speaking
Meals & Travel
Research
Novo Nordisk Inc
$21
Top 3 companies account for 100.0% of 2023 payments
All-time payments by company (2018-2023) ›
Amgen Inc.
$65
Vertiflex, Inc.
$42
Scilex Pharmaceuticals Inc.
$25
Novo Nordisk Inc
$21
ARBOR PHARMACEUTICALS, INC.
$17
Astellas Pharma US Inc
$16
Synergy Pharmaceuticals Inc
$15
Ultragenyx Pharmaceutical Inc.
$15
Top 3 companies account for 61.1% of all-time payments
Associated products mentioned in payments ›
Aimovig · CRYSVITA · Edarbi · MYRBETRIQ · Repatha · Rybelsus · Superion ISS · Trulance · ZTLido 30 POUCH in 1 CARTON 1 PATCH in 1 POUCH
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (100%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Family medicine physicians within 10 mi
3,066
Per 100K population
31.1
County median income
$87,760
Nearest hospital
EMANATE HEALTH INTER-COMMUNITY HOSPITAL
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2023 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Usborne is a clinical cardiology specialist, with above-average Medicare volume (top 4% in CA), with low-engagement industry engagement, with 19 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Usborne experienced with office visit, established patient (30-39 min)?
Based on Medicare claims data, Dr. Usborne performed 522 office visit, established patient (30-39 min) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Usborne receive payments from pharmaceutical companies?
Yes. Dr. Usborne received a total of $216 from 8 companies across 12 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Usborne's costs compare to other family medicine physicians in Covina?
Dr. Usborne's average Medicare payment per service is $62. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Usborne) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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