BRISTOL SURGERY CENTER, LLC

NPI: 1013964063 · BRISTOL, TN 37620 · Ambulatory Surgical Clinic/Center · NPI assigned 05/27/2006

$81K

Total Medicaid Paid

304

Total Claims

268

Beneficiaries

Codes Billed

2018-01

First Month

2018-10

Last Month

Provider Details

Authorized Official	WILLIAMS, KAREN (ADMINISTRATOR)
NPI Enumeration Date	05/27/2006

Other providers sharing the same authorized official: WILLIAMS, KAREN

Provider	City	State	Total Paid
WABASH OHIO VALLEY SPECIAL EDUCATION CFC 23	NORRIS CITY	IL	$1.08M
BYERS FIRE PROTECTION DISTRICT NO 9	BYERS	CO	$2K
KAREN A. WILLIAMS, MD, PC	WATERTOWN	NY	$896.86

Year	Claims	Total Paid
2018	304	$81K

Code	Description	Claims	Beneficiaries	Total Paid
41899	Unlisted procedure, dentoalveolar structures	164	158	$81K
G8918	Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis	70	55	$0.00
G8907	Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility	70	55	$0.00