LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.

$353K

Total Medicaid Paid

7,283

Total Claims

6,718

Beneficiaries

26

Codes Billed

2019-02

First Month

2020-09

Last Month

Authorized Official	D'AMATO, AMY (CONTRACTS MANAGER)
NPI Enumeration Date	07/07/2018

Provider	City	State	Total Paid
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.	VENTURA	CA	$617K
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.	SALINAS	CA	$374K
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.	PORTLAND	OR	$4K
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.	SACRAMENTO	CA	$640.91

Year	Claims	Total Paid
2019	3,931	$194K
2020	3,352	$159K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	4,048	3,904	$150K
95886		351	344	$46K
64493		395	216	$39K
95911		153	153	$28K
64494		380	207	$19K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	616	602	$14K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	206	203	$14K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	179	179	$10K
64635		34	32	$6K
11104		54	54	$6K
11105		54	54	$4K
95913		16	16	$3K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	221	219	$3K
64490		22	12	$2K
20611		45	42	$2K
64636		35	32	$2K
S0020	Injection, bupivicaine hydrochloride, 30 ml	134	131	$1K
64491		21	12	$1K
20526		19	13	$524.93
76942		12	12	$395.69
J1100	Injection, dexamethasone sodium phosphate, 1 mg	71	66	$351.02
99406		31	31	$322.71
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	17	17	$303.17
99000		63	61	$214.17
J1040	Injection, methylprednisolone acetate, 80 mg	12	12	$207.84
99490	Ccm add 20min	94	94	$0.00

Medicaid Provider Spending