BEAUREGARD MEDICAL AND SURGICAL CENTER, LLC

NPI: 1326348962 · DERIDDER, LA 70634 · Family Medicine Physician · NPI assigned 10/29/2010

$25K

Total Medicaid Paid

963

Total Claims

852

Beneficiaries

Codes Billed

2018-01

First Month

2019-08

Last Month

Provider Details

Authorized Official	KINGHAM, DARRELL (CFO)
Parent Organization	WEST LOUISIANA HEALTH SERVICES, INC.
NPI Enumeration Date	10/29/2010

Other providers sharing the same authorized official: KINGHAM, DARRELL

Provider	City	State	Total Paid
BEAUREGARD FAMILY MEDICAL CENTER, LLC	DERIDDER	LA	$206K
BEAUREGARD URGENT CARE CENTER, LLC	DERIDDER	LA	$163K
BEAUREGARD SURGERY CENTER, LLC	DERIDDER	LA	$51K
BEAUREGARD INTERNAL MEDICINE CENTER, LLC	DERIDDER	LA	$12K
BEAUREGARD UROLOGY CENTER, LLC	DERIDDER	LA	$7K

Year	Claims	Total Paid
2018	825	$23K
2019	138	$2K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	527	457	$21K
99308	Subsequent nursing facility care, per day, straightforward	198	182	$2K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	58	47	$1K
36415	Collection of venous blood by venipuncture	168	154	$301.00
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	12	12	$161.70