LAS COLINAS MEDICAL GROUP, INC.

NPI: 1114944923 · SAN JOSE, CA 95127 · Primary Care Clinic/Center · NPI assigned 07/16/2006

$1K

Total Medicaid Paid

1,403

Total Claims

1,237

Beneficiaries

Codes Billed

2018-01

First Month

2019-05

Last Month

Provider Details

Authorized Official	RAMIREZ, ALFREDO (M.D.)
NPI Enumeration Date	07/16/2006

Other providers sharing the same authorized official: RAMIREZ, ALFREDO

Provider	City	State	Total Paid
ALFREDO RAMIREZ JUSTINIANO NEFROLOGO CSP	MAYAGUEZ	PR	$349K

Year	Claims	Total Paid
2018	953	$708.85
2019	450	$419.68

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1,189	1,030	$982.29
99490	Ccm add 20min	75	71	$136.16
90756		41	41	$10.08
99487	Ccm add 20min	28	28	$0.00
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	54	53	$0.00
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	16	14	$0.00