Physician
Southwest Spine and Pain Care Specialists, LLC
Southwest Spine and Pain Care Specialists, LLC was paid $4.06M by Medicaid between Jan 2018 and Dec 2024, across 61 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 43% of everything it billed.
33Billing provider infoSOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC
SAINT GEORGE, UT 84791
SAINT GEORGE, UT 84791
33aNPI1144509985assigned 08/10/2011
33bProvider typeNeurology Physician
28Total paid$4.06M
24GClaims108,228
24DCodes billed61
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Neurology Physician providers in Utah
Rank by total paid#1 of 18
Median peer was paid$101K
This provider vs. median40×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 8,357 | $236K | |
| 2019 | 12,317 | $402K | |
| 2020 | 11,633 | $437K | |
| 2021 | 18,513 | $730K | |
| 2022 | 20,041 | $857K | |
| 2023 | 16,741 | $818K | |
| 2024incomplete | 20,626 | $579K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 43% | 33,618 | 28,172 | $1.75M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 35% | 40,339 | 33,635 | $1.40M |
| 62323 | 5.7% | 1,911 | 1,734 | $230K | |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 4.5% | 2,463 | 2,291 | $184K |
| 64635 | 2.4% | 434 | 350 | $98K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.4% | 1,162 | 1,096 | $96K |
| 62321 | 1.1% | 331 | 323 | $46K | |
| 64636 | 1.1% | 428 | 326 | $44K | |
| 64493 | <1% | 267 | 251 | $31K | |
| 27096 | <1% | 292 | 262 | $25K | |
| 64494 | <1% | 414 | 223 | $22K | |
| 80305 | <1% | 5,300 | 4,631 | $11K |
49 more codes
| 99152 | <1% | 579 | $11K | |
| 76881 | <1% | 259 | $10K | |
| 76882 | <1% | 701 | $9K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 10,086 | $8K |
| 77002 | <1% | 315 | $7K | |
| 20553 | <1% | 229 | $7K | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 5,962 | $7K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 66 | $6K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 102 | $6K |
| 20610 | <1% | 189 | $6K | |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | <1% | 63 | $5K |
| 76942 | <1% | 123 | $4K | |
| 20611 | <1% | 80 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 81 | $2K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 42 | $2K |
| 64483 | <1% | 13 | $2K | |
| 99205 | Prolong outpt/office vis | <1% | 15 | $2K |
| 80371 | <1% | 45 | $1K | |
| 80368 | <1% | 45 | $1K | |
| 80353 | <1% | 45 | $1K | |
| 80367 | <1% | 45 | $1K | |
| 80358 | <1% | 45 | $1K | |
| 80359 | <1% | 45 | $1K | |
| 80354 | <1% | 45 | $1K | |
| 80348 | <1% | 45 | $1K | |
| 80366 | <1% | 45 | $1K | |
| 80370 | <1% | 45 | $1K | |
| 80361 | <1% | 45 | $1K | |
| 80373 | <1% | 45 | $1K | |
| 80360 | <1% | 45 | $1K | |
| 80372 | <1% | 45 | $1K | |
| 80365 | <1% | 45 | $1K | |
| 80325 | <1% | 45 | $1K | |
| 80346 | <1% | 45 | $1K | |
| 80355 | <1% | 45 | $1K | |
| 80053 | Comprehensive metabolic panel | <1% | 38 | $889.90 |
| 83992 | <1% | 45 | $870.80 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 129 | $703.64 |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | <1% | 14 | $336.87 |
| 98980 | <1% | 17 | $291.12 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 503 | $267.93 |
| 36415 | Collection of venous blood by venipuncture | <1% | 81 | $248.87 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 580 | $133.27 |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 15 | $53.78 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 25 | $46.60 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 12 | $8.06 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 39 | $6.21 |
| 98977 | 0% | 18 | $0.00 | |
| 85652 | 0% | 38 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialPFATENHAUER, ASHLEY (CREDENTIALING & CONTRACTING MANAGER)