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NPI Detail
NPI: 1578094462
Type: Organization
Taxonomy Code: 261QA1903X
Ambulatory Surgical Center
Ambulatory Health Care Facilities/Clinic-Center, Ambulatory Surgical
2416 XXXX XXX
JACKSONVILLE, FL 322184604
Business phone: (XXX) XXX-XXXX
Mailing address phone: (XXX) XXX-XXXX
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2021 Part B Medicare Services Submitted*
| HCPCS Code △ ▽ |
Line Service
Count
△ ▽ |
Unique Beneficiary
Count
△ ▽ |
Average Submitted
Charge Amount
△ ▽ |
Average Medicare
Payment Amount
△ ▽ |
Total Medicare
Payment
△ ▽ |
|
XXXXX
|
Insertion of needle and/or catheter into dialysis circuit, with imaging including radiological supervision and interpretation |
XX
|
12 |
$1789.00 |
$342.43 |
$
X,XXX.XX
|
|
XXXXX
|
Insertion of needle and/or catheter into dialysis circuit and balloon dilation of dialysis segment, with imaging including radiological supervision and interpretation |
XX
|
49 |
$7077.00 |
$1510.61 |
$
XX,XXX.XX
|
|
XXXXX
|
Insertion of needle and/or catheter into dialysis circuit and insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation |
XX
|
12 |
$21084.00 |
$4466.70 |
$
XX,XXX.XX
|
|
Total Medicare Payments: |
$XXXXXX.XX
|
* Source:
2021 Medicare Provider Utilization and Payment Data: Physician and Other Supplier
Medicare Referring Provider DMEPOS PUF, CY2021
2021 OPPS Part A Medicare Services Submitted NPI-1578094462*
OPPS Payment Method "A" - Services not paid under OPPS; uses a different fee schedule (e.g., ambulance, PT, mammography)
Top Level I HCPC Procedures
| Procedure | Description | Number Submitted | Medicare Payment |
| 36902
|
INTRO CATH DIALYSIS CIRCUIT
|
XXX
|
$XXXXXXX.XX
|
| 37187
|
VENOUS MECH THROMBECTOMY
|
XXX
|
$XXXXXX.XX
|
| 36907
|
BALO ANGIOP CTR DIALYSIS SEG
|
XXX
|
-
|
| 75710
|
ARTERY X-RAYS ARM/LEG
|
XXX
|
-
|
| 36589
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REMOVAL TUNNELED CV CATH
|
XXX
|
$XXXXX.XX
|
| 36581
|
REPLACE TUNNELED CV CATH
|
XXX
|
$XXXXX.XX
|
| 36901
|
INTRO CATH DIALYSIS CIRCUIT
|
XX
|
$XXXXXX.XX
|
| 36595
|
MECH REMOV TUNNELED CV CATH
|
XX
|
$XXXXX.XX
|
| 36905
|
THRMBC/NFS DIALYSIS CIRCUIT
|
XX
|
$XXXXXX.XX
|
| 36903
|
INTRO CATH DIALYSIS CIRCUIT
|
XX
|
$XXXXXX.XX
|
| 75827
|
VEIN X-RAY CHEST
|
XX
|
$XXXX.XX
|
| 36906
|
THRMBC/NFS DIALYSIS CIRCUIT
|
XX
|
$XXXXXX.XX
|
| 36909
|
DIALYSIS CIRCUIT EMBOLJ
|
XX
|
-
|
| 75822
|
VEIN X-RAY ARMS/LEGS
|
XX
|
$XXXXX.XX
|
| 36558
|
INSERT TUNNELED CV CATH
|
XX
|
$XXXXX.XX
|
| 36215
|
PLACE CATHETER IN ARTERY
|
XX
|
-
|
| 37248
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TRLUML BALO ANGIOP 1ST VEIN
|
XX
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$XXXXX.XX
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| 37607
|
LIGATION OF A-V FISTULA
|
XX
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$XXXXX.XX
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| 75820
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VEIN X-RAY ARM/LEG
|
XX
|
$XXXXX.XX
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| 36908
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STENT PLMT CTR DIALYSIS SEG
|
XX
|
-
|
| 36005
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INJECTION EXT VENOGRAPHY
|
XX
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-
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Top Drugs Administered Other than Oral Method
| Procedure | Description | Number Submitted | Medicare Payment |
Top HCPC Level II Procedures / Professional Services
| Procedure | Description | Number Submitted | Medicare Payment |
| G0463
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Hospital outpt clinic visit
|
XX
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$XXXX.X
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| G2170
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Avf by tissue w thermal e
|
XX
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$XXXXXX.XX
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* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
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