SAN ANTONIO VASCULAR SPECIALISTS CORP

NPI: 1093371163 · SAN ANTONIO, TX 78240 · Vascular-Interventional Technology Radiologic Technologist · NPI assigned 05/14/2019

$8K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2020-11

First Month

2020-11

Last Month

Provider Details

Authorized Official	GAMPEL, YURY (MANAGER)
NPI Enumeration Date	05/14/2019

Other providers sharing the same authorized official: GAMPEL, YURY

Provider	City	State	Total Paid
MODERN VASCULAR OF GLENDALE, LLC	GLENDALE	AZ	$780K
MODERN VASCULAR - NAVAJO LLC	ALBUQUERQUE	NM	$248K
MODERN VASCULAR OF SOUTHAVEN, LLC	SOUTHAVEN	MS	$85K
MODERN VASCULAR OF DENVER, LLC	THORNTON	CO	$44K
PAIN MANAGEMENT & REHABILITATION MEDICINE CENTER PC	MESA	AZ	$17K
MODERN VASCULAR OF ST LOUIS LLC	CREVE COEUR	MO	$17K
MODERN VASCULAR OF SUN CITY, LLC	SURPRISE	AZ	$5K
MODERN VASCULAR OF TUCSON, LLC	TUCSON	AZ	$4K
INDIANAPOLIS VASCULAR SPECIALISTS CORP	INDIANAPOLIS	IN	$282.71

Year	Claims	Total Paid
2020	70	$8K

Code	Description	Claims	Beneficiaries	Total Paid
37252		18	13	$6K
37253		17	12	$2K
76937		18	13	$139.17
G9500	Radiation exposure indices documented in final report for procedure using fluoroscopy	17	13	$0.00