NPI: 1578174983 · EDMOND, OK 73034 · Pediatrics Physician · NPI assigned 08/11/2020
Authorized official PENA, CRYSTAL controls 20+ related entities in our dataset. Read more
| Authorized Official | PENA, CRYSTAL (PROVIDER ENROLLMENT COORDINATOR) |
| Parent Organization | SSM HEALTH CARE OF OKLAHOMA, INC. |
| NPI Enumeration Date | 08/11/2020 |
Other providers sharing the same authorized official: PENA, CRYSTAL
| Provider | City | State | Total Paid |
|---|---|---|---|
| SAINT MEDICAL GROUP, LLC | EL RENO | OK | $1.42M |
| SSM HEALTHCARE OF OK, INC | OKLAHOMA CITY | OK | $1.42M |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $1.36M |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $1.17M |
| SAINT MEDICAL GROUP, LLC | EL RENO | OK | $1.15M |
| SAINTS MEDICAL GROUP, LLC | MUSTANG | OK | $904K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $896K |
| SHAWNEE MEDICAL CENTER CLINIC, INC. | SEMINOLE | OK | $828K |
| SSM HEALTH CARE OF OKLAHOMA INC | OKLAHOMA CITY | OK | $751K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $640K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $614K |
| SAINT MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $551K |
| SSM HEALTHCARE OF OK, INC | OKLAHOMA CITY | OK | $535K |
| SAINT MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $494K |
| SAINTS MEDICAL GROUP, LLC | PURCELL | OK | $455K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $368K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $357K |
| SAINT MEDICAL GROUP, LLC | HARRAH | OK | $343K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $315K |
| SSM HEALTHCARE OF OKLAHOMA, INC | OKLAHOMA CITY | OK | $183K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 142 | $7K |
| 2022 | 480 | $28K |
| 2023 | 868 | $55K |
| 2024 | 397 | $27K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1,145 | 1,087 | $85K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 410 | 403 | $20K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 204 | 203 | $4K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 37 | 36 | $4K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 33 | 30 | $3K |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 28 | 28 | $3K |
| 90674 | 30 | 30 | $0.00 |