INDIANAPOLIS VASCULAR SPECIALISTS CORP

NPI: 1164037289 · INDIANAPOLIS, IN 46260 · Vascular-Interventional Technology Radiologic Technologist · NPI assigned 09/15/2020

$282.71

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2021-06

First Month

2021-06

Last Month

Provider Details

Authorized Official	GAMPEL, YURY (MANAGER)
NPI Enumeration Date	09/15/2020

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
SAN ANTONIO VASCULAR SPECIALISTS CORP	SAN ANTONIO	TX	$8K
MODERN VASCULAR OF SUN CITY, LLC	SURPRISE	AZ	$5K
MODERN VASCULAR OF TUCSON, LLC	TUCSON	AZ	$4K

Year	Claims	Total Paid
2021	16	$282.71

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	16	12	$282.71