4TH STREET LASER & SURGERY CENTER INC
NPI: 1902964174
· SANTA ROSA, CA 95404
· Ambulatory Surgical Clinic/Center
· NPI assigned 12/04/2006
$164K
Total Medicaid Paid
Provider Details
| Authorized Official | CLARK, ELAYNE (ADMINISTRATOR) |
| NPI Enumeration Date | 12/04/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
121 |
$14K |
| 2019 |
107 |
$21K |
| 2020 |
51 |
$9K |
| 2021 |
77 |
$12K |
| 2022 |
109 |
$17K |
| 2023 |
332 |
$52K |
| 2024 |
248 |
$39K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
1,013 |
779 |
$164K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
32 |
29 |
$0.00 |