NPI: 1982351979 · CHOCTAW, OK 73020 · Family Medicine Physician · NPI assigned 03/09/2022
Authorized official PENA, CRYSTAL controls 20+ related entities in our dataset. Read more
| Authorized Official | PENA, CRYSTAL (PROVIDER ENROLLMENT) |
| Parent Organization | SSM HEALTH CARE OF OKLAHOMA, INC. |
| NPI Enumeration Date | 03/09/2022 |
Other providers sharing the same authorized official: PENA, CRYSTAL
| Provider | City | State | Total Paid |
|---|---|---|---|
| SAINT MEDICAL GROUP, LLC | EL RENO | OK | $1.42M |
| SSM HEALTHCARE OF OK, INC | OKLAHOMA CITY | OK | $1.42M |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $1.36M |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $1.17M |
| SAINT MEDICAL GROUP, LLC | EL RENO | OK | $1.15M |
| SAINTS MEDICAL GROUP, LLC | MUSTANG | OK | $904K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $896K |
| SHAWNEE MEDICAL CENTER CLINIC, INC. | SEMINOLE | OK | $828K |
| SSM HEALTH CARE OF OKLAHOMA INC | OKLAHOMA CITY | OK | $751K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $640K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $614K |
| SAINT MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $551K |
| SSM HEALTHCARE OF OK, INC | OKLAHOMA CITY | OK | $535K |
| SAINT MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $494K |
| SAINTS MEDICAL GROUP, LLC | PURCELL | OK | $455K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $368K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $357K |
| SAINT MEDICAL GROUP, LLC | HARRAH | OK | $343K |
| SAINTS MEDICAL GROUP, LLC | OKLAHOMA CITY | OK | $315K |
| SSM HEALTHCARE OF OKLAHOMA, INC | OKLAHOMA CITY | OK | $183K |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,575 | $104K |
| 2023 | 2,825 | $209K |
| 2024 | 2,154 | $161K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3,284 | 3,169 | $245K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 1,817 | 1,762 | $186K |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 236 | 236 | $23K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 361 | 359 | $7K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 53 | 53 | $5K |
| 36415 | Collection of venous blood by venipuncture | 595 | 577 | $3K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 116 | 116 | $3K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 31 | 31 | $3K |
| 90686 | 49 | 49 | $205.40 | |
| 90715 | 12 | 12 | $0.00 |