DR. JAIME ELIEZER GIRON MD
NPI 1346321197
Family Medicine - Geriatric Medicine in Soledad, CA

Medicare Participation & PECOS Enrollment Status

Jaime Giron is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jaime Giron is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 345324059

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20080219000703

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE017N)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  7 DME suppliers used 155 Medicare Claims 302 Services Paid

• DME-Other DME (DE000N)

  Normal, low and high calibrator solution / chips (HCPCS:A4256)

  2 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lancets, per box of 100 (HCPCS:A4259)

  6 DME suppliers used 46 Medicare Claims 70 Services Paid

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  2 DME suppliers used 43 Medicare Claims 43 Services Paid

• DME-Other DME (DE017N)

  Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

  6 DME suppliers used 112 Medicare Claims 112 Services Paid

• DME-Other DME (DE017N)

  Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system (HCPCS:K0554)

  3 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

  2 DME suppliers used 13 Medicare Claims 13 Services Paid

Drugs Administered Through DME

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

  3 DME suppliers used 13 Medicare Claims 1230 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of drug for helicobacter pylori

Administering drugs for Helicobacter pylori involves taking a combination of antibiotics and proton pump inhibitors. This dual therapy helps to eliminate the bacteria from your stomach, reducing symptoms and preventing stomach ulcers or cancer.

This service was performed 23 times for 16 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

This service was performed 21 times for 19 patients

Blood count, hemoglobin

A blood count, specifically hemoglobin, is a standard test that measures the amount of hemoglobin in your blood. Hemoglobin is a protein in red blood cells that carries oxygen throughout your body. This test helps assess your overall health and detect a variety of disorders such as anemia or polycythemia.

This service was performed 73 times for 52 patients

Blood glucose (sugar) test performed by hand-held instrument

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

This service was performed 458 times for 223 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 200 times for 123 patients

Breath test analysis for helicobacter pylori

A breath test for Helicobacter pylori is a non-invasive procedure that helps detect bacteria causing stomach issues. You'll swallow a harmless substance containing a special carbon atom. If the bacteria are present, they'll release this atom in your breath, which can be detected.

This service was performed 26 times for 18 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 16 times for 16 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

This service was performed 46 times for 44 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

This service was performed 19 times for 18 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 441 times for 220 patients

Limited ultrasound scan of abdomen

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

This service was performed 15 times for 14 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

This service was performed 25 times for 25 patients

Screening 3d breast mammography

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

This service was performed 53 times for 53 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 53 times for 53 patients

Testing for presence of drug, read by direct observation

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

This service was performed 12 times for 12 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 101 times for 73 patients

Urine microalbumin (protein) analysis

Urine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.

This service was performed 23 times for 22 patients

X-ray of ankle, minimum of 3 views

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

This service was performed 11 times for 11 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 21 times for 20 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 17 times for 16 patients

X-ray of hip, 2-3 views

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

This service was performed 12 times for 12 patients

X-ray of knee, 3 views

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

This service was performed 24 times for 20 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 21 times for 21 patients

X-ray of shoulder, minimum of 2 views

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

This service was performed 13 times for 12 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.61 for a new patient copayment and $27.01 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 93960 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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