Clinic
Pony Creek Annex, LLC
Pony Creek Annex, LLC was paid $91K by Medicaid between May 2022 and Oct 2024, across 1 billing code. Its largest line is 66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis — 100% of everything it billed.
33Billing provider infoPONY CREEK ANNEX, LLC
NORTH BEND, OR 97459
NORTH BEND, OR 97459
33aNPI1538736459assigned 06/09/2021
33bProvider typeAmbulatory Surgical Clinic/Center
28Total paid$91K
24GClaims311
24DCodes billed1
24AFirst – last monthMay 2022 – Oct 2024
Compared with peers
Next to other Ambulatory Surgical Clinic/Center providers in Oregon
Rank by total paid#32 of 55
Median peer was paid$153K
This provider vs. median0.6×
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 | |
|---|---|---|---|
| 2022 | 110 | $25K | |
| 2023 | 131 | $39K | |
| 2024incomplete | 70 | $27K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 100% | 311 | 229 | $91K |
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 officialGILBERT, JANE (MEDICAL DIRECTOR)