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NPI Detail
NPI: 1750308763
Type: Organization
Taxonomy Code: 261QA1903X
Ambulatory Surgical Center
Ambulatory Health Care Facilities/Clinic-Center, Ambulatory Surgical
860 XXX XXXX XXXX
102
ARROYO GRANDE, CA 934201800
Mailing and Business location 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
|
Repair of knee joint, lower or upper part of joint, inside and outside area |
XX
|
20 |
$45000.00 |
$8291.77 |
$
XXX,XXX.XX
|
|
XXXXX
|
Removal of recurring cataract in lens capsule using laser |
XX
|
18 |
$1500.00 |
$197.60 |
$
X,XXX.XX
|
|
XXXXX
|
Removal of cataract with insertion of lens, simple |
XXX
|
85 |
$2500.00 |
$936.15 |
$
XXX,XXX.XX
|
|
XXXXX
|
Injection, bupivacaine liposome, 1 mg |
XXXX
|
23 |
$ 2.52 |
$ 1.03 |
$
X,XXX.XX
|
|
Total Medicare Payments: |
$XXXXXX.XX
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* 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-1750308763*
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 |
| 66984
|
XCAPSL CTRC RMVL W/O ECP
|
XXX
|
$XXXXXX.XX
|
| 76942
|
ECHO GUIDE FOR BIOPSY
|
XXX
|
-
|
| 64447
|
NJX AA&/STRD FEMORAL NRV IMG
|
XXX
|
-
|
| 27447
|
TOTAL KNEE ARTHROPLASTY
|
XXX
|
$XXXXXXX.XX
|
| 67904
|
REPAIR EYELID DEFECT
|
XX
|
$XXXX.XX
|
| 66821
|
AFTER CATARACT LASER SURGERY
|
XX
|
$XXXXX.XX
|
| 64640
|
INJECTION TREATMENT OF NERVE
|
XX
|
$XXXXX.XX
|
| 67900
|
REPAIR BROW DEFECT
|
XX
|
-
|
| 27130
|
TOTAL HIP ARTHROPLASTY
|
XX
|
$XXXXXX.XX
|
| 15823
|
REVISION OF UPPER EYELID
|
XX
|
-
|
| 66982
|
XCAPSL CTRC RMVL CPLX WO ECP
|
XX
|
$XXXXX.XX
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Top Drugs Administered Other than Oral Method
| Procedure | Description | Number Submitted | Medicare Payment |
| J1095
|
Injection, dexamethasone 9%
|
XXXXX
|
$XXXXX.XX
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| J2704
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Inj, propofol, 10 mg
|
XXXXX
|
-
|
| J0171
|
Adrenalin epinephrine inject
|
XXXX
|
-
|
| J1096
|
Dexametha opth insert 0.1 mg
|
XXXX
|
-
|
| J2250
|
Inj midazolam hydrochloride
|
XXXX
|
-
|
| J3301
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Triamcinolone acet inj nos
|
XXXX
|
-
|
| J0690
|
Cefazolin sodium injection
|
XXX
|
-
|
| J1100
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Dexamethasone sodium phos
|
XXX
|
-
|
| J2405
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Ondansetron hcl injection
|
XXX
|
-
|
| J3010
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Fentanyl citrate injection
|
XXX
|
-
|
| J1885
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Ketorolac tromethamine inj
|
XXX
|
-
|
| J7120
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Ringers lactate infusion
|
XXX
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-
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| J2280
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Inj, moxifloxacin 100 mg
|
XXX
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-
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| J2370
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Phenylephrine hcl injection
|
XXX
|
-
|
| J3370
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Vancomycin hcl injection
|
XXX
|
-
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| J0131
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Inj, acetaminophen (nos)
|
XXX
|
-
|
| J2765
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Metoclopramide hcl injection
|
XX
|
-
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Top HCPC Level II Procedures / Professional Services
| Procedure | Description | Number Submitted | Medicare Payment |
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
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