Apex Physical Medicine and Rehabilitation Professional LLC
Apex Physical Medicine and Rehabilitation Professional LLC was paid $4.54M by Medicaid between Jan 2018 and Oct 2024, across 31 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 57% of everything it billed.
33Billing provider infoAPEX PHYSICAL MEDICINE AND REHABILITATION PROFESSIONAL LLC
COLORADO SPRINGS, CO 80917
COLORADO SPRINGS, CO 80917
33aNPI1326229287assigned 11/20/2007
33bProvider typeChiropractor
28Total paid$4.54M
24GClaims59,816
24DCodes billed31
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Chiropractor providers in Colorado
Rank by total paid#1 of 13
Median peer was paid$88K
This provider vs. median52×
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 | 2,005 | $32K | |
| 2019 | 1,443 | $39K | |
| 2020 | 1,519 | $77K | |
| 2021 | 1,049 | $27K | |
| 2022 | 1,620 | $161K | |
| 2023 | 19,901 | $1.48M | |
| 2024incomplete | 32,279 | $2.72M |
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 | 57% | 29,928 | 10,501 | $2.57M |
| 96132 | 19% | 8,663 | 3,611 | $848K | |
| 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 | 9.7% | 4,788 | 4,516 | $441K |
| 96137 | 3.1% | 3,024 | 2,747 | $141K | |
| 96136 | 2.7% | 2,035 | 1,994 | $121K | |
| J3490 | Unclassified drugs | 2.5% | 550 | 330 | $114K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 2.2% | 4,814 | 4,538 | $101K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.4% | 1,759 | 1,453 | $64K |
| 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 | 1.1% | 689 | 617 | $50K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 596 | 370 | $15K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | <1% | 171 | 142 | $15K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 296 | 177 | $13K |
19 more codes
| 96116 | <1% | 134 | $11K | |
| G3002 | Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) | <1% | 292 | $8K |
| 20561 | <1% | 179 | $6K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 68 | $5K |
| G3003 | Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.) | <1% | 252 | $5K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 258 | $4K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 169 | $3K |
| 99439 | <1% | 175 | $3K | |
| 99490 | Ccm add 20min | <1% | 177 | $2K |
| 99407 | <1% | 192 | $1K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 18 | $65.10 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 148 | $34.80 |
| J2060 | Injection, lorazepam, 2 mg | <1% | 69 | $31.50 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 66 | $10.16 |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 0% | 102 | $0.00 |
| G0480 | 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; 1-7 drug class(es), including metabolite(s) if performed | 0% | 12 | $0.00 |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 90 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 89 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 13 | $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 officialCOPELAND, HEATHER (OFFICE MANAGER)