WEST LAKES SURGERY CENTER LLC
NPI: 1104933696
· CLIVE, IA 50325
· Ambulatory Surgical Clinic/Center
· NPI assigned 08/23/2006
$1.12M
Total Medicaid Paid
Provider Details
| Authorized Official | FORMANEK, TERI (PRESIDENT) |
| NPI Enumeration Date | 08/23/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
544 |
$209K |
| 2019 |
421 |
$181K |
| 2020 |
214 |
$96K |
| 2021 |
201 |
$97K |
| 2022 |
339 |
$164K |
| 2023 |
406 |
$211K |
| 2024 |
286 |
$164K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,764 |
1,674 |
$832K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
419 |
390 |
$233K |
| 62323 |
|
81 |
77 |
$19K |
| 42830 |
|
29 |
29 |
$16K |
| 15769 |
|
13 |
12 |
$12K |
| 64635 |
|
25 |
12 |
$4K |
| 69631 |
|
15 |
12 |
$4K |
| 62321 |
|
12 |
12 |
$2K |
| 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 |
53 |
40 |
$0.00 |