SOUTH MIAMI ASC, LLC

NPI: 1811497159 · MIAMI, FL 33156 · Ambulatory Surgical Clinic/Center · NPI assigned 02/13/2018

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official LARSEN, DEVIN controls 20+ related entities in our dataset. Read more

$220K

Total Medicaid Paid

2,165

Total Claims

1,402

Beneficiaries

Codes Billed

2024-05

First Month

2024-12

Last Month

Provider Details

Authorized Official	LARSEN, DEVIN (CEO)
NPI Enumeration Date	02/13/2018

Other providers sharing the same authorized official: LARSEN, DEVIN

Provider	City	State	Total Paid
VALLARINE DENTAL CORPORATION	FRESNO	CA	$38.23M
COFFEE SURGERY CENTER, LLC	BAKERSFIELD	CA	$14.86M
KC CHILDRENS SURGERY CENTER LLC	KANSAS CITY	KS	$13.76M
HOUSTON CHILDREN'S DENTAL CENTER, LLC	HOUSTON	TX	$11.03M
DENTAL SURGICENTER OF LOUISVILLE LLC	LOUISVILLE	KY	$8.44M
DENTAL SURGERY CENTERS OF AMERICA	ATWATER	CA	$7.22M
DENTAL SURGERY CENTERS OF AMERICA	STOCKTON	CA	$6.82M
JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC	JACKSONVILLE	FL	$6.31M
MEDICAL AND DENTAL CENTER OF NEVADA LLC	LAS VEGAS	NV	$6.00M
SAN ANTONIO CHILDRENS SURGICAL	SAN ANTONIO	TX	$4.91M
CHILDREN 1ST HOUSTON SOUTH, LLC	HOUSTON	TX	$3.69M
FORT MYERS CHILDREN'S SURGERY CENTER, LLC	FT MYERS	FL	$3.42M
VISALIA CHILDREN'S DENTAL SURGERY CENTER INC	VISALIA	CA	$3.35M
CHILDREN 1ST GRAND PRAIRIE, LLC	GRAND PRAIRIE	TX	$3.31M
DENTAL SURGERY CENTERS OF AMERICA	SANTA MARIA	CA	$2.66M
WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC	PALM SPRINGS	FL	$1.63M
BLUE CLOUD ANESTHESIA, LLC	TAMPA	FL	$1.57M
SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC	RALEIGH	NC	$1.38M
BLUE CLOUD ANESTHESIA, LLC	ORLANDO	FL	$1.36M
DENTAL SURGICENTER OF LOUISVILLE LLC	LOUISVILLE	KY	$965K

Year	Claims	Total Paid
2024	2,165	$220K

Code	Description	Claims	Beneficiaries	Total Paid
D2930	Prefabricated stainless steel crown - primary tooth	554	169	$100K
D7140	Extraction, erupted tooth or exposed root	329	127	$81K
D9420		219	211	$30K
D2391	Resin-based composite - one surface, posterior, primary or permanent	15	12	$4K
D2330		57	38	$3K
D3120		35	26	$533.52
D0210	Intraoral - complete series of radiographic images	186	178	$0.00
D1330		188	180	$0.00
D1351	Sealant - per tooth	183	78	$0.00
D0150	Comprehensive oral evaluation - new or established patient	201	193	$0.00
D0603		198	190	$0.00