533 SOUTH FAIRFAX AVENUE INC

NPI: 1639166242 · LOS ANGELES, CA 90036 · Skilled Nursing Facility · NPI assigned 09/29/2005

$28K

Total Medicaid Paid

1,975

Total Claims

218

Beneficiaries

Codes Billed

2019-12

First Month

2020-09

Last Month

Provider Details

Authorized Official	SANCHEZ, ROSALIE (MANAGER)
NPI Enumeration Date	09/29/2005

Other providers sharing the same authorized official: SANCHEZ, ROSALIE

Provider	City	State	Total Paid
8520 WESTERN AVENUE INC	BUENA PARK	CA	$28K
GARDEN GROVE CONVALESCENT HOSPITAL INC	GARDEN GROVE	CA	$13K
1135 N LEISURE CT INC	ANAHEIM	CA	$6K
PACIFIC CARE NURSING CENTER	LONG BEACH	CA	$5K
COMMUNITY CONVALESCENT CENTER OF MONTCLAIR INC	MONTCLAIR	CA	$4K
12232 CHAPMAN AVE INC	GARDEN GROVE	CA	$0.00

Year	Claims	Total Paid
2019	286	$2K
2020	1,689	$26K

Code	Description	Claims	Beneficiaries	Total Paid
97112	Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination	873	77	$14K
97530	Therapeutic activities, direct patient contact, each 15 minutes	580	38	$7K
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	333	42	$5K
97535	Self-care/home management training, each 15 minutes	120	24	$1K
Q3014	Telehealth originating site facility fee	69	37	$921.93