NPI: 1265843122 · SAN YSIDRO, CA 92173 · PACE Provider Organization · NPI assigned 05/14/2014
Authorized official MATTSON, KEVIN controls 16+ related entities in our dataset. Read more
| Authorized Official | MATTSON, KEVIN (PRESIDENT/CEO) |
| Parent Organization | CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. |
| NPI Enumeration Date | 05/14/2014 |
Other providers sharing the same authorized official: MATTSON, KEVIN
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 5,420 | $1.04M |
| 2019 | 8,867 | $1.47M |
| 2020 | 22,460 | $2.49M |
| 2021 | 23,395 | $1.28M |
| 2022 | 8,822 | $441K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 30,541 | 28,798 | $6.70M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7,243 | 7,092 | $14K |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 174 | 168 | $5K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7,063 | 6,783 | $2K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 65 | 64 | $1K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 4,080 | 3,975 | $707.00 |
| 90662 | 85 | 85 | $64.79 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 710 | 706 | $16.90 |
| 82962 | 465 | 460 | $3.96 | |
| 36415 | Collection of venous blood by venipuncture | 1,471 | 1,457 | $2.70 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 2,697 | 2,524 | $0.25 |
| S9452 | Nutrition classes, non-physician provider, per session | 1,697 | 1,647 | $0.00 |
| 3074F | 359 | 354 | $0.00 | |
| S9451 | Exercise classes, non-physician provider, per session | 1,536 | 1,489 | $0.00 |
| 3079F | 180 | 179 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 307 | 307 | $0.00 |
| G9664 | Patients who are currently statin therapy users or received an order (prescription) for statin therapy | 255 | 253 | $0.00 |
| 3008F | 1,935 | 1,881 | $0.00 | |
| 93000 | 480 | 476 | $0.00 | |
| 99000 | 704 | 695 | $0.00 | |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | 12 | 12 | $0.00 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 14 | 14 | $0.00 |
| 3075F | 169 | 169 | $0.00 | |
| 1000F | 87 | 85 | $0.00 | |
| 90688 | 241 | 241 | $0.00 | |
| 3044F | 309 | 307 | $0.00 | |
| 1126F | 76 | 75 | $0.00 | |
| 90686 | 79 | 79 | $0.00 | |
| 4010F | 50 | 50 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 118 | 118 | $0.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 14 | 13 | $0.00 |
| 1159F | 3,754 | 3,508 | $0.00 | |
| 1158F | 570 | 548 | $0.00 | |
| 82947 | 169 | 168 | $0.00 | |
| 81002 | 25 | 25 | $0.00 | |
| 3078F | 643 | 632 | $0.00 | |
| 3077F | 278 | 275 | $0.00 | |
| 3051F | 29 | 28 | $0.00 | |
| 1160F | 49 | 49 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 178 | 169 | $0.00 |
| 3046F | 15 | 15 | $0.00 | |
| 99215 | Prolong outpt/office vis | 12 | 12 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 26 | 26 | $0.00 |