GHC OF LAKESIDE, LLC

NPI: 1790789170 · LAKESIDE, CA 92040 · Skilled Nursing Facility · NPI assigned 06/13/2005

$52K

Total Medicaid Paid

3,515

Total Claims

400

Beneficiaries

Codes Billed

2022-06

First Month

2023-05

Last Month

Provider Details

Authorized Official	MASTROCOLA, LOIS (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date	06/13/2005

Other providers sharing the same authorized official: MASTROCOLA, LOIS

Provider	City	State	Total Paid
GHC OF SAC-RCFE, LLC	SACRAMENTO	CA	$8.27M
GHC OF UPLAND RCFE, LLC	UPLAND	CA	$3.64M
GHC OF SAN JOSE, LLC	SAN JOSE	CA	$98K
GHC OF CANOGA PARK, LLC	CANOGA PARK	CA	$20K
GHC OF EL CAJON, LLC	EL CAJON	CA	$10K
GHC OF DALY CITY 239, LLC	DALY CITY	CA	$4K
GHC OF SUNNYVALE, LLC	SUNNYVALE	CA	$904.59

Year	Claims	Total Paid
2022	1,770	$37K
2023	1,745	$15K

Code	Description	Claims	Beneficiaries	Total Paid
97530	Therapeutic activities, direct patient contact, each 15 minutes	1,391	120	$14K
97129		841	85	$14K
97116		464	50	$8K
97535	Self-care/home management training, each 15 minutes	417	53	$6K
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	53	12	$4K
97112	Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination	93	27	$3K
97130		256	53	$3K