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NPI Detail
NPI: 1780752352
Type: Organization
Taxonomy Code: 261QA1903X
Ambulatory Surgical Center
Ambulatory Health Care Facilities/Clinic-Center, Ambulatory Surgical
816 XXXX XXXX XXXXX
B
SANTA MARIA, CA 93454
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
|
Internal insertion of eye fluid drainage device |
XX
|
31 |
$9000.00 |
$2723.63 |
$
XXX,XXX.XX
|
|
XXXXX
|
Dilation to improve eye fluid flow |
XX
|
16 |
$3500.00 |
$953.43 |
$
XX,XXX.XX
|
|
XXXXX
|
Creation of shunt to improve eye fluid flow with graft |
XX
|
11 |
$3500.00 |
$2446.96 |
$
XX,XXX.XX
|
|
XXXXX
|
Removal of recurring cataract in lens capsule using laser |
XX
|
57 |
$1500.00 |
$224.05 |
$
XX,XXX.XX
|
|
XXXXX
|
Removal of cataract with insertion of lens, complex |
XX
|
26 |
$2500.00 |
$894.96 |
$
XX,XXX.XX
|
|
XXXXX
|
Removal of cataract with insertion of lens, simple |
XXX
|
260 |
$2517.43 |
$934.42 |
$
XXX,XXX.XX
|
|
XXXXX
|
Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina |
XX
|
14 |
$6500.00 |
$1823.23 |
$
XX,XXX.XX
|
|
XXXXX
|
Repair of defect of sclera with graft |
XX
|
11 |
$4500.00 |
$506.22 |
$
X,XXX.XX
|
|
XXXXX
|
Injection, dexamethasone 9 percent, intraocular, 1 microgram |
XXXXX
|
20 |
$ 1.11 |
$ 0.83 |
$
X,XXX.XX
|
|
Total Medicare Payments: |
$XXXXXX.XXXXXX
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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-1780752352*
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
|
$XXXXXXX.XX
|
| 00142
|
ANESTH LENS SURGERY
|
XXX
|
-
|
| 66821
|
AFTER CATARACT LASER SURGERY
|
XXX
|
$XXXXX.XX
|
| 66982
|
XCAPSL CTRC RMVL CPLX WO ECP
|
XX
|
$XXXXXX.XX
|
| 66174
|
TRLUML DIL AQ O/F CAN W/O ST
|
XX
|
$XXXX.XX
|
| 65820
|
RELIEVE INNER EYE PRESSURE
|
XX
|
-
|
| 66710
|
CILIARY TRANSSLERAL THERAPY
|
XX
|
$XXXXX.XX
|
| 66030
|
INJECTION TREATMENT OF EYE
|
XX
|
$XXXXX.XX
|
| 67042
|
VIT FOR MACULAR HOLE
|
XX
|
$XXXXX.XX
|
| 66180
|
AQUEOUS SHUNT EYE W/GRAFT
|
XX
|
$XXXXX.XX
|
| 67255
|
REINFORCE/GRAFT EYE WALL
|
XX
|
-
|
| 65426
|
REMOVAL OF EYE LESION
|
XX
|
$XXXXX.XX
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| 67039
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LASER TREATMENT OF RETINA
|
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
|
$XXXXX.XX
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| J2250
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Inj midazolam hydrochloride
|
XXX
|
-
|
| J2280
|
Inj, moxifloxacin 100 mg
|
XXX
|
-
|
| J0171
|
Adrenalin epinephrine inject
|
XXX
|
-
|
| J7316
|
Inj, ocriplasmin, 0.125 mg
|
XXX
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$XXXX.XX
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| J7351
|
Inj bimatoprost itc imp1mcg
|
XXX
|
$XXXXX.XX
|
| J9280
|
Mitomycin injection
|
XX
|
-
|
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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