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AMBULATORY SURGERY CENTER OF BURLEY, LLC
AMBULATORY SURGERY CENTER OF BURLEY, LLC
NPI: 1992706840
· BURLEY, ID 83318
· Certified Registered Nurse Anesthetist
· NPI assigned 08/02/2005
$561K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: PETERSEN, JOSEPH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
181 |
$87K |
| 2019 |
237 |
$143K |
| 2020 |
330 |
$144K |
| 2021 |
189 |
$67K |
| 2022 |
302 |
$90K |
| 2023 |
90 |
$29K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
586 |
547 |
$335K |
| T1015 |
Clinic visit/encounter, all-inclusive |
328 |
327 |
$201K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
274 |
273 |
$9K |
| 64483 |
|
27 |
16 |
$5K |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
24 |
14 |
$4K |
| 62321 |
|
13 |
13 |
$3K |
| 99152 |
|
12 |
12 |
$2K |
| D9420 |
|
15 |
15 |
$1K |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$165.67 |
| D7140 |
Extraction, erupted tooth or exposed root |
12 |
12 |
$0.00 |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
26 |
25 |
$0.00 |