Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › NY › Hornell › NPI 1013985399
Hospital

ST James Hospital

ST James Hospital was paid $18.25M by Medicaid between Jan 2018 and Dec 2024, across 225 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 14% of everything it billed.

33Billing provider infoST JAMES HOSPITAL
HORNELL, NY 14843
33aNPI1013985399assigned 03/10/2006
33bProvider typeRural Acute Care Hospital
28Total paid$18.25M
24GClaims374,902
24DCodes billed225
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Rural Acute Care Hospital providers in New York

Rank by total paid#3 of 7
Median peer was paid$13.87M
This provider vs. median1.3×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

$0$200K$400K$600K2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
20185,732$237K
201919,704$849K
202051,287$2.20M
202170,501$3.35M
202276,037$4.95M
202386,056$3.94M
2024incomplete65,585$2.73M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 14% 33,268 30,989 $2.63M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 13% 19,426 17,260 $2.40M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 9.9% 20,640 19,693 $1.80M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 7.1% 10,327 9,422 $1.29M
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 6.3% 13,183 12,357 $1.14M
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 5.7% 11,440 9,820 $1.04M
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 3.9% 10,053 9,038 $719K
96361 Intravenous infusion, hydration; each additional hour 3.1% 2,227 2,012 $570K
99282 Emergency department visit for the evaluation and management, low to moderate severity 3.1% 3,852 3,657 $558K
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 2.3% 2,613 2,454 $420K
80053 Comprehensive metabolic panel 2.2% 17,852 16,091 $405K
36415 Collection of venous blood by venipuncture 2.1% 13,504 11,654 $388K
213 more codes
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 2.1% 6,632 $387K
74177 Computed tomography, abdomen and pelvis; with contrast material 2.1% 1,579 $382K
99203 Doctor's office visit, new patient (routine) 1.9% 3,528 $349K
70450 Computed tomography, head or brain; without contrast material 1.6% 1,082 $299K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1.5% 2,983 $272K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1.3% 1,514 $237K
81025 1.2% 1,979 $213K
87631 1.1% 2,008 $209K
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 <1% 6,705 $159K
77067 Screening mammography, bilateral, including computer-aided detection <1% 2,206 $126K
80048 Basic metabolic panel (calcium, ionized) <1% 5,330 $111K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 2,489 $104K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 443 $99K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 3,096 $92K
99204 Doctor's office visit, new patient (more involved) <1% 821 $89K
20610 <1% 575 $89K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 363 $86K
97161 <1% 1,010 $84K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 843 $73K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 1,863 $68K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 1,771 $61K
80061 Lipid panel <1% 6,512 $52K
84443 Thyroid stimulating hormone (TSH) <1% 7,998 $51K
S5161 Emergency response system; service fee, per month (excludes installation and testing) <1% 1,457 $45K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 319 $44K
87081 <1% 7,869 $43K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 328 $41K
84484 <1% 2,676 $40K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 17,946 $36K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 1,826 $36K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 142 $32K
83036 Hemoglobin; glycosylated (A1C) <1% 4,315 $32K
90686 <1% 794 $31K
71275 Computed tomographic angiography, chest, with contrast material <1% 105 $30K
77063 Screening digital breast tomosynthesis, bilateral <1% 1,509 $30K
84439 <1% 4,251 $27K
73130 <1% 1,079 $26K
73110 <1% 806 $24K
87086 Culture, bacterial; quantitative colony count, urine <1% 3,906 $23K
51798 <1% 90 $22K
73562 <1% 416 $20K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 2,741 $20K
12001 <1% 40 $20K
82607 <1% 1,803 $19K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 1,288 $19K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 491 $17K
76830 Ultrasound, transvaginal <1% 538 $16K
71046 Radiologic examination, chest; 2 views <1% 3,519 $16K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 138 $16K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 4,647 $16K
71045 Radiologic examination, chest; single view <1% 2,275 $14K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 849 $14K
11721 <1% 648 $14K
82728 <1% 1,242 $14K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 2,222 $13K
76770 <1% 112 $13K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,573 $13K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 106 $13K
84703 <1% 1,902 $12K
76642 <1% 259 $11K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 526 $10K
86803 <1% 1,291 $10K
86780 <1% 831 $10K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 211 $9K
80076 <1% 1,150 $9K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 91 $9K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 295 $9K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 160 $8K
83655 <1% 588 $8K
85380 <1% 634 $8K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 89 $8K
86900 <1% 421 $8K
99201 <1% 97 $7K
84702 <1% 768 $7K
87340 <1% 750 $7K
83540 <1% 1,671 $7K
83735 <1% 3,031 $6K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 3,992 $6K
85027 <1% 2,666 $6K
85610 <1% 2,391 $6K
73630 <1% 1,391 $5K
76000 <1% 39 $5K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 149 $5K
83880 <1% 151 $5K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 12 $5K
76641 <1% 117 $4K
86850 <1% 389 $4K
73610 <1% 1,290 $4K
81003 <1% 3,697 $4K
86901 <1% 386 $4K
99385 <1% 28 $4K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 24 $4K
90715 <1% 146 $4K
86618 <1% 313 $4K
81001 <1% 3,187 $4K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 41 $4K
77065 Tomosynthesis, mammo <1% 53 $3K
99442 <1% 126 $3K
87480 <1% 549 $3K
83550 <1% 753 $3K
82746 <1% 281 $3K
86140 <1% 1,308 $3K
84466 <1% 300 $3K
84403 <1% 121 $3K
72020 <1% 12 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 4,185 $3K
93971 <1% 83 $3K
G0378 Hospital observation service, per hour <1% 99 $3K
73030 <1% 697 $3K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml <1% 44 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 838 $3K
86762 <1% 196 $3K
85652 <1% 1,597 $2K
87660 <1% 446 $2K
86706 <1% 300 $2K
87510 <1% 513 $2K
82043 <1% 454 $2K
82570 <1% 641 $2K
87186 <1% 1,200 $2K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 2,026 $2K
96375 Therapeutic injection; each additional sequential IV push <1% 3,129 $2K
86704 <1% 235 $2K
77066 Tomosynthesis, mammo <1% 25 $2K
97165 <1% 25 $2K
99215 Doctor's office visit, returning patient (complex) <1% 14 $2K
83690 <1% 1,954 $2K
11720 <1% 74 $1K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 50 $1K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 634 $1K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 53 $1K
87070 <1% 355 $1K
0012A <1% 38 $1K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc <1% 31 $1K
72125 Computed tomography, cervical spine; without contrast material <1% 12 $1K
76536 <1% 64 $1K
A9576 Injection, gadoteridol, (prohance multipack), per ml <1% 27 $1K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 12 $1K
86038 <1% 210 $1K
72100 <1% 145 $929.84
87420 <1% 382 $916.61
74018 <1% 260 $890.32
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,398 $823.50
73564 <1% 114 $720.56
84100 <1% 322 $697.51
83001 <1% 38 $666.92
73140 <1% 243 $661.24
87158 <1% 2,171 $651.88
86708 <1% 76 $643.04
99441 <1% 34 $573.75
73560 <1% 103 $528.65
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 50 $497.16
83605 <1% 916 $493.10
85730 <1% 334 $445.82
0011A <1% 31 $396.90
85007 <1% 433 $373.37
86617 <1% 17 $371.76
G0103 Prostate cancer screening; prostate specific antigen test (psa) <1% 41 $350.85
72110 <1% 27 $346.04
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision <1% 13 $324.15
73502 <1% 103 $316.39
87040 <1% 589 $314.33
84146 <1% 17 $310.08
86430 <1% 64 $259.64
87205 <1% 265 $256.36
99443 <1% 15 $253.00
J7120 Ringers lactate infusion, up to 1000 cc <1% 1,342 $236.63
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen <1% 308 $214.41
87400 <1% 512 $179.92
81002 <1% 165 $176.57
82150 <1% 155 $168.38
96376 <1% 699 $159.88
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 45 $141.10
73080 <1% 89 $116.51
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 49 $104.21
86364 <1% 13 $90.74
82247 <1% 68 $87.84
82550 <1% 42 $75.75
86308 <1% 25 $71.70
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 118 $66.87
84460 <1% 36 $60.45
73090 <1% 30 $60.00
82950 <1% 12 $57.00
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 2,145 $56.04
80179 <1% 278 $44.73
80143 <1% 310 $44.73
80306 <1% 84 $30.05
82805 <1% 28 $24.13
84155 <1% 37 $22.02
73590 <1% 12 $18.18
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 1,682 $15.17
J2704 Injection, propofol, 10 mg <1% 787 $10.26
82040 <1% 25 $9.90
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 16 $8.48
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg <1% 307 $7.67
94760 <1% 155 $7.41
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 712 $7.30
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 207 $5.17
J0690 Injection, cefazolin sodium, 500 mg <1% 225 $3.34
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg <1% 121 $2.14
J2270 Injection, morphine sulfate, up to 10 mg <1% 96 $1.17
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 13 $1.11
J2003 Injection, lidocaine hydrochloride, 1 mg <1% 48 $0.50
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 173 $0.48
82077 0% 77 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 0% 89 $0.00
J1170 Injection, hydromorphone, up to 4 mg 0% 190 $0.00
J2060 Injection, lorazepam, 2 mg 0% 64 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 0% 315 $0.00
J1630 Injection, haloperidol, up to 5 mg 0% 12 $0.00
93000 0% 27 $0.00
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 0% 14 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 0% 12 $0.00
J1171 Injection, hydromorphone, 0.1 mg 0% 13 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialBECHER, DENISE (DIRECTOR DECISION SUPPORT)