SYCAMORE AVENUE MEDICAL CENTER, PLLC
NPI: 1245762491
· KINGMAN, AZ 86409
· 363LF0000X
$501K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,671 |
$148K |
| 2019 |
3,245 |
$140K |
| 2020 |
2,100 |
$99K |
| 2021 |
1,679 |
$81K |
| 2022 |
569 |
$33K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
5,006 |
4,488 |
$264K |
| 99213 |
|
3,202 |
2,879 |
$112K |
| 99204 |
|
550 |
532 |
$45K |
| 99215 |
Prolong outpt/office vis |
376 |
345 |
$26K |
| 99203 |
|
286 |
273 |
$15K |
| 99212 |
|
661 |
618 |
$15K |
| 96372 |
|
490 |
426 |
$8K |
| 99205 |
Prolong outpt/office vis |
43 |
43 |
$5K |
| 99385 |
|
64 |
61 |
$5K |
| 99386 |
|
47 |
46 |
$4K |
| 99396 |
|
18 |
16 |
$894.48 |
| 99202 |
|
12 |
12 |
$522.48 |
| J3301 |
Triamcinolone acet inj nos |
96 |
92 |
$447.23 |
| 90471 |
|
21 |
19 |
$166.23 |
| 92551 |
|
15 |
15 |
$134.10 |
| 99441 |
|
15 |
14 |
$103.56 |
| 99000 |
|
23 |
16 |
$37.65 |
| J0696 |
Ceftriaxone sodium injection |
18 |
18 |
$35.60 |
| 99173 |
|
15 |
15 |
$35.24 |
| J3420 |
Vitamin b12 injection |
17 |
16 |
$34.16 |
| J1100 |
Dexamethasone sodium phos |
61 |
57 |
$17.53 |
| 99072 |
|
184 |
153 |
$0.00 |
| 99406 |
|
19 |
14 |
$0.00 |
| 99407 |
|
25 |
12 |
$0.00 |