Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

ST. JOSEPH HEALTH SYSTEM, LLC

NPI: 1023060472 · FORT WAYNE, IN 46802 · General Acute Care Hospital · NPI assigned 05/16/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LALOR, PAULA controls 20+ related entities in our dataset. Read more

$25.43M
Total Medicaid Paid
450,882
Total Claims
336,261
Beneficiaries
135
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLALOR, PAULA (DIRECTOR/DELEGATED OFFICIAL)
NPI Enumeration Date05/16/2006

Related Entities

Other providers sharing the same authorized official: LALOR, PAULA

ProviderCityStateTotal Paid
NORTHWEST HOSPITAL LLC TUCSON AZ $47.81M
ROSWELL HOSPITAL CORPORATION ROSWELL NM $41.27M
WESLEY HEALTH SYSTEM LLC HATTIESBURG MS $37.82M
METRO KNOXVILLE HMA LLC POWELL TN $28.70M
BULLHEAD CITY HOSPITAL CORPORATION BULLHEAD CITY AZ $28.54M
IOM HEALTH SYSTEM LP FORT WAYNE IN $27.50M
LAREDO TEXAS HOSPITAL COMPANY LP LAREDO TX $19.46M
OAK HILL HOSPITAL CORPORATION OAK HILL WV $18.77M
COCKE COUNTY HMA, LLC NEWPORT TN $18.34M
CLEVELAND TENNESSEE HOSPITAL COMPANY LLC CLEVELAND TN $16.31M
JEFFERSON COUNTY HMA LLC JEFFERSON CITY TN $14.31M
NORTHWEST ARKANSAS HOSPITALS, LLC SPRINGDALE AR $11.46M
PETERSBURG HOSPITAL COMPANY LLC PETERSBURG VA $11.20M
CAMPBELL COUNTY HMA, LLC LAFOLLETTE TN $10.07M
WARSAW HEALTH SYSTEM LLC WARSAW IN $9.95M
LONGVIEW MEDICAL CENTER LP LONGVIEW TX $9.29M
MOBERLY HOSPITAL COMPANY LLC MOBERLY MO $8.61M
CRESTVIEW HOSPITAL COMPANY, LLC CRESTVIEW FL $8.15M
KIRKSVILLE MISSOURI HOSPITAL COMPANY, LLC KIRKSVILLE MO $7.98M
VICTORIA OF TEXAS LP VICTORIA TX $7.74M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 55,282 $1.00M
2019 44,990 $1.73M
2020 37,007 $1.61M
2021 46,159 $2.70M
2022 105,495 $6.87M
2023 99,069 $6.68M
2024 62,880 $4.83M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99283 Emergency department visit for the evaluation and management, moderate severity 46,226 38,790 $7.79M
99284 Emergency department visit for the evaluation and management, high severity 34,364 27,231 $5.85M
71045 Radiologic examination, chest; single view 12,679 9,885 $1.81M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 10,070 7,558 $1.57M
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 21,576 15,249 $1.42M
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 11,212 8,952 $769K
99282 Emergency department visit for the evaluation and management, low to moderate severity 5,988 5,196 $704K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 266 236 $655K
74177 Computed tomography, abdomen and pelvis; with contrast material 923 670 $391K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 12,860 10,628 $366K
70450 Computed tomography, head or brain; without contrast material 2,321 1,746 $282K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 2,648 2,000 $269K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 538 371 $225K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 13,065 6,504 $201K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 35,349 25,747 $169K
99217 431 326 $161K
99218 443 336 $158K
80053 Comprehensive metabolic panel 23,185 17,300 $153K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 10,744 8,365 $132K
99221 366 258 $126K
93017 872 626 $126K
41899 Unlisted procedure, dentoalveolar structures 160 99 $123K
36415 Collection of venous blood by venipuncture 55,917 40,020 $123K
45380 Colonoscopy, flexible; with biopsy, single or multiple 76 54 $120K
99238 Hospital discharge day management, 30 minutes or less 388 271 $119K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 108 69 $119K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 330 246 $118K
71046 Radiologic examination, chest; 2 views 1,304 1,068 $118K
96361 Intravenous infusion, hydration; each additional hour 7,322 5,544 $116K
84484 15,471 8,729 $108K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2,137 1,597 $87K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,520 3,169 $79K
96375 Therapeutic injection; each additional sequential IV push 5,412 3,799 $61K
80048 Basic metabolic panel (calcium, ionized) 12,598 8,593 $56K
80050 General health panel 338 314 $50K
G0378 Hospital observation service, per hour 276 156 $49K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1,489 1,286 $38K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1,490 1,287 $38K
80061 Lipid panel 4,661 3,900 $35K
81001 16,125 12,631 $31K
81025 4,765 3,796 $30K
83690 8,435 6,279 $30K
74176 Computed tomography, abdomen and pelvis; without contrast material 116 88 $28K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 203 176 $27K
87430 1,864 1,611 $27K
71275 Computed tomographic angiography, chest, with contrast material 71 51 $26K
16020 158 95 $21K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 755 675 $18K
83735 4,805 2,933 $18K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 17 12 $18K
J2785 Injection, regadenoson, 0.1 mg 407 290 $17K
99281 Emergency department visit for the evaluation and management, self-limited or minor 375 318 $16K
72125 Computed tomography, cervical spine; without contrast material 85 65 $16K
87086 Culture, bacterial; quantitative colony count, urine 2,907 2,282 $15K
93246 55 41 $14K
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 210 174 $14K
83036 Hemoglobin; glycosylated (A1C) 2,515 2,081 $14K
85027 5,073 3,836 $12K
84443 Thyroid stimulating hormone (TSH) 1,131 891 $12K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 738 423 $10K
90870 275 113 $10K
82947 5,096 3,028 $9K
80076 2,653 2,079 $9K
82077 670 500 $8K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 283 207 $8K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 412 373 $7K
87400 1,043 449 $7K
83880 333 211 $6K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 517 277 $6K
87807 464 417 $6K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 28 25 $5K
93242 18 12 $5K
84703 809 613 $5K
80051 2,361 1,822 $4K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 269 235 $4K
82565 2,364 1,825 $3K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 166 129 $3K
84520 2,381 1,835 $2K
87340 429 388 $2K
81003 906 692 $1K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 61 54 $1K
83605 210 119 $1K
88305 Level IV - Surgical pathology, gross and microscopic examination 230 124 $1K
85379 173 118 $1K
85610 538 389 $1K
86592 364 325 $1K
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 42 33 $1K
82248 285 219 $963.85
73630 37 25 $792.78
97161 21 13 $745.84
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 85 73 $660.03
82607 65 51 $575.01
J3490 Unclassified drugs 28 26 $474.18
87641 58 37 $462.33
82550 110 84 $448.75
87040 92 30 $374.62
84145 22 15 $326.64
84238 15 12 $302.41
88342 15 12 $297.14
82746 35 27 $231.54
84403 16 14 $227.19
82728 35 27 $212.34
85730 84 68 $199.60
J1885 Injection, ketorolac tromethamine, per 15 mg 7,749 6,037 $194.61
84439 44 38 $193.85
87077 33 25 $185.84
86803 16 13 $165.27
84702 16 14 $159.76
84100 53 28 $137.46
83550 34 26 $127.73
83540 34 26 $94.58
82043 43 30 $85.35
87210 31 26 $84.60
J2405 Injection, ondansetron hydrochloride, per 1 mg 2,810 2,130 $80.59
96376 296 98 $73.71
81000 23 18 $67.95
84550 16 14 $39.77
86900 14 12 $27.37
86901 14 12 $27.37
J2270 Injection, morphine sulfate, up to 10 mg 368 270 $27.15
J7030 Infusion, normal saline solution , 1000 cc 2,508 2,164 $0.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 102 81 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 17 17 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 13 13 $0.00
0202U Oncology (prostate), multianalyte, gene expression profiling 13 12 $0.00
90715 16 12 $0.00
J2704 Injection, propofol, 10 mg 379 200 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 152 113 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 242 96 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 263 226 $0.00
J2765 Injection, metoclopramide hcl, up to 10 mg 66 61 $0.00
J8540 Dexamethasone, oral, 0.25 mg 361 287 $0.00
A9270 Non-covered item or service 96 89 $0.00
J0690 Injection, cefazolin sodium, 500 mg 12 12 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 17 13 $0.00