KENTUCKY MSO LLC

NPI: 1508101460 · GEORGETOWN, KY 40324 · Vascular Surgery Physician · NPI assigned 12/04/2012

$265K

Total Medicaid Paid

3,018

Total Claims

2,330

Beneficiaries

Codes Billed

2018-03

First Month

2024-06

Last Month

Provider Details

Authorized Official	VAUGHN, TIMOTHY (VICE PRESIDENT)
NPI Enumeration Date	12/04/2012

Other providers sharing the same authorized official: VAUGHN, TIMOTHY

Provider	City	State	Total Paid
DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC	HENDERSON	NC	$424K
DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC	HENDERSON	NC	$322K
LAKE CUMBERLAND PHYSICIAN PRACTICES	SOMERSET	KY	$247K
KENTUCKY MSO LLC	GEORGETOWN	KY	$119K
CASTLEVIEW PHYSICIAN PRACTICES, LLC	PRICE	UT	$11K
DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC	HENDERSON	NC	$11K

Code	Description	Claims	Beneficiaries	Total Paid
43775		318	228	$180K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	954	773	$41K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	255	228	$34K
43659		21	12	$8K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	125	98	$2K
1160F		336	246	$0.00
1159F		336	246	$0.00
3725F		17	12	$0.00
S2900	Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)	218	160	$0.00
1036F		382	286	$0.00
3008F		56	41	$0.00