OPTUMCARE ENDOSCOPY CENTER NEW MEXICO, LLC

NPI: 1962685834 · ALBUQUERQUE, NM 87108 · Ambulatory Surgical Clinic/Center · NPI assigned 12/13/2007

$9K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-06

First Month

2018-07

Last Month

Provider Details

Authorized Official	LIETHEN, JOHN (SECRETARY)
Parent Organization	DAVITA MEDICAL GROUP NEW MEXICO, LLC
NPI Enumeration Date	12/13/2007

Other providers sharing the same authorized official: LIETHEN, JOHN

Provider	City	State	Total Paid
HEALTHCARE PARTNERS ASC-HB, LLC	HUNTINGTON BEACH	CA	$4.05M
TALBERT MEDICAL GROUP, P.C.	FOUNTAIN VALLEY	CA	$4.00M
DAVITA MEDICAL GROUP TALBERT CALIFORNIA, P.C.	ANAHEIM	CA	$3.74M
TALBERT MEDICAL GROUP, P.C.	HUNTINGTON BEACH	CA	$3.73M
OPTUMCARE NEW MEXICO, LLC	ALBUQUERQUE	NM	$241K
OPTUMCARE COLORADO ASC, LLC	COLORADO SPRINGS	CO	$87K
ARTA WESTERN CALIFORNIA, INC.	IRVINE	CA	$31K
TALBERT MEDICAL GROUP, P.C.	SANTA ANA	CA	$10K
TALBERT MEDICAL GROUP, P.C.	COMPTON	CA	$1K

Year	Claims	Total Paid
2018	28	$9K

Code	Description	Claims	Beneficiaries	Total Paid
45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s)	13	13	$5K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	15	15	$4K