ST DOMINIC AMBULATORY SURGERY CENTER L L C
NPI: 1255303517
· JACKSON, MS 39216
· 261QA1903X
$221K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
997 |
$44K |
| 2019 |
976 |
$54K |
| 2020 |
677 |
$37K |
| 2021 |
741 |
$54K |
| 2022 |
224 |
$24K |
| 2023 |
69 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 62323 |
|
1,684 |
1,490 |
$177K |
| 64493 |
|
175 |
110 |
$23K |
| 62321 |
|
92 |
79 |
$10K |
| 64635 |
|
31 |
26 |
$8K |
| 64483 |
|
15 |
15 |
$2K |
| 20610 |
|
102 |
76 |
$1K |
| 27096 |
|
18 |
12 |
$400.63 |
| 64495 |
|
102 |
84 |
$146.30 |
| 64494 |
|
102 |
84 |
$0.00 |
| G8907 |
Pt doc no events on discharg |
1,268 |
1,184 |
$0.00 |
| 64636 |
|
38 |
15 |
$0.00 |
| 77002 |
|
12 |
12 |
$0.00 |
| G8918 |
Pt w/o preop order iv ab pro |
45 |
42 |
$0.00 |