Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

Mount ST. Mary's Hospital of Niagara Falls

Mount ST. Mary's Hospital of Niagara Falls was paid $22.19M by Medicaid between Jan 2018 and Dec 2024, across 295 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 29% of everything it billed.

33Billing provider infoMOUNT ST. MARY'S HOSPITAL OF NIAGARA FALLS
LEWISTON, NY 14092
33aNPI1043394745assigned 10/25/2006
28Total paid$22.19M
24GClaims588,718
24DCodes billed295
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Cardiac Rehabilitation Clinic/Center providers in New York

Rank by total paid#2 of 5
Median peer was paid$13.42M
This provider vs. median1.7×

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
20185,203$349K
201939,956$1.16M
202080,496$2.20M
2021100,216$3.74M
2022106,837$4.20M
2023125,487$5.41M
2024incomplete130,523$5.13M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
G0463 Hospital outpatient clinic visit for assessment and management of a patient 29% 62,424 51,399 $6.50M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 11% 15,536 14,847 $2.39M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 8.2% 11,777 11,075 $1.82M
G0378 Hospital observation service, per hour 5.8% 1,327 830 $1.28M
96361 Intravenous infusion, hydration; each additional hour 4.0% 4,913 4,552 $880K
99282 Emergency department visit for the evaluation and management, low to moderate severity 3.8% 6,004 5,864 $851K
74177 Computed tomography, abdomen and pelvis; with contrast material 2.5% 2,485 2,422 $553K
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 2.4% 6,793 6,441 $530K
70450 Computed tomography, head or brain; without contrast material 2.0% 2,119 2,076 $445K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2.0% 22,015 17,912 $443K
80053 Comprehensive metabolic panel 1.8% 25,616 22,516 $394K
74176 Computed tomography, abdomen and pelvis; without contrast material 1.4% 1,419 1,390 $314K
283 more codes
99285 Emergency room visit (most serious) 1.4% 1,843 $310K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.1% 2,447 $253K
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 1.1% 4,154 $242K
99213 Doctor's office visit, returning patient (routine) <1% 3,820 $214K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 7,151 $200K
36415 Collection of venous blood by venipuncture <1% 32,353 $180K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 4,132 $173K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 1,245 $167K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 327 $151K
99201 <1% 1,385 $140K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 7,078 $137K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 1,487 $134K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 4,711 $133K
77067 Screening mammography, bilateral, including computer-aided detection <1% 2,307 $121K
87481 <1% 3,425 $121K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 4,319 $119K
87631 <1% 2,628 $116K
71275 Computed tomographic angiography, chest, with contrast material <1% 516 $114K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 1,717 $103K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 2,274 $92K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 790 $85K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 1,163 $83K
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 1,391 $74K
97597 <1% 274 $71K
20610 <1% 317 $70K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) <1% 42 $69K
70551 Magnetic resonance imaging, brain; without contrast material <1% 301 $69K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 6,446 $69K
80048 Basic metabolic panel (calcium, ionized) <1% 4,684 $65K
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% 3,231 $61K
76830 Ultrasound, transvaginal <1% 1,537 $55K
84443 Thyroid stimulating hormone (TSH) <1% 7,513 $54K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 392 $51K
99442 <1% 736 $50K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 1,561 $50K
80061 Lipid panel <1% 7,269 $49K
90715 <1% 1,927 $49K
97161 <1% 792 $47K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 1,013 $47K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 767 $46K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 717 $46K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 1,829 $44K
83036 Hemoglobin; glycosylated (A1C) <1% 6,018 $43K
12001 <1% 114 $40K
69210 <1% 1,383 $40K
82607 <1% 4,295 $40K
76801 <1% 550 $38K
86850 <1% 1,778 $37K
71046 Radiologic examination, chest; 2 views <1% 5,894 $31K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 24,847 $31K
99203 Doctor's office visit, new patient (routine) <1% 384 $30K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 349 $29K
83880 <1% 1,253 $29K
90686 <1% 1,063 $27K
84439 <1% 3,465 $27K
99441 <1% 323 $27K
93017 <1% 909 $26K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 306 $25K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 1,426 $24K
99204 Doctor's office visit, new patient (more involved) <1% 215 $24K
86900 <1% 2,109 $22K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 1,006 $22K
81025 <1% 7,646 $22K
76641 <1% 906 $22K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 3,562 $20K
77063 Screening digital breast tomosynthesis, bilateral <1% 2,200 $19K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 192 $18K
82803 <1% 862 $17K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 10,848 $17K
93976 <1% 42 $16K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 2,351 $16K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 51 $16K
82746 <1% 1,477 $15K
93971 <1% 314 $15K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 1,644 $15K
87563 <1% 698 $13K
82728 <1% 1,171 $13K
87660 <1% 6,495 $11K
87086 Culture, bacterial; quantitative colony count, urine <1% 5,859 $11K
Q9957 Injection, perflutren lipid microspheres, per ml <1% 129 $11K
84702 <1% 2,001 $11K
93970 <1% 53 $11K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml <1% 271 $11K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 8,431 $10K
90682 <1% 378 $10K
85027 <1% 4,072 $10K
86803 <1% 1,598 $10K
72125 Computed tomography, cervical spine; without contrast material <1% 274 $9K
81001 <1% 10,494 $9K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 66 $9K
86701 <1% 977 $9K
99221 <1% 110 $9K
76536 <1% 427 $8K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 3,530 $7K
83921 <1% 473 $7K
71271 <1% 323 $7K
86901 <1% 476 $7K
80076 <1% 759 $7K
82043 <1% 1,527 $6K
85610 <1% 4,191 $6K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 288 $6K
86762 <1% 610 $6K
76818 <1% 158 $6K
83550 <1% 1,350 $5K
87340 <1% 754 $5K
99443 <1% 69 $5K
87088 <1% 1,771 $5K
90670 <1% 134 $5K
85730 <1% 3,581 $5K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 50 $4K
59025 Fetal non-stress test <1% 108 $4K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose <1% 54 $4K
12011 <1% 13 $4K
93225 <1% 220 $4K
70486 <1% 45 $4K
J2785 Injection, regadenoson, 0.1 mg <1% 41 $4K
83735 <1% 3,625 $4K
90656 <1% 260 $4K
76813 <1% 63 $3K
71250 <1% 53 $3K
31575 <1% 126 $3K
71045 Radiologic examination, chest; single view <1% 3,960 $3K
87077 <1% 2,202 $3K
90734 <1% 144 $3K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 168 $3K
99406 <1% 92 $3K
84153 <1% 197 $3K
83655 <1% 201 $3K
87186 <1% 1,960 $3K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 13 $3K
81003 <1% 4,951 $2K
73630 <1% 1,144 $2K
73030 <1% 751 $2K
96375 Therapeutic injection; each additional sequential IV push <1% 5,578 $2K
87480 <1% 1,726 $2K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 30 $2K
87510 <1% 1,724 $2K
83690 <1% 5,717 $2K
72100 <1% 365 $2K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism <1% 56 $2K
31231 <1% 168 $2K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg <1% 1,111 $2K
85652 <1% 1,218 $2K
86787 <1% 297 $2K
86885 <1% 54 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 5,000 $2K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 67 $1K
97162 <1% 13 $1K
J7120 Ringers lactate infusion, up to 1000 cc <1% 3,703 $1K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 73 $1K
82150 <1% 2,924 $1K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 40 $1K
95819 <1% 39 $1K
99385 <1% 19 $1K
81513 <1% 3,455 $1K
88304 <1% 230 $1K
83001 <1% 89 $1K
82570 <1% 275 $1K
72110 <1% 81 $1K
90651 <1% 36 $1K
86140 <1% 424 $1K
99000 <1% 247 $1K
73562 <1% 440 $1K
95886 <1% 32 $1K
83540 <1% 202 $988.04
G0297 Low dose ct scan (ldct) for lung cancer screening <1% 12 $952.03
73130 <1% 654 $942.73
73610 <1% 829 $913.82
97010 <1% 53 $903.33
73564 <1% 286 $897.24
82784 <1% 59 $878.78
86480 <1% 14 $826.82
90677 <1% 12 $779.45
74018 <1% 308 $762.56
84484 <1% 6,394 $730.30
73502 <1% 202 $725.71
84550 <1% 213 $640.98
86580 <1% 137 $632.15
86003 <1% 21 $632.07
86038 <1% 153 $579.08
82950 <1% 144 $571.47
G0103 Prostate cancer screening; prostate specific antigen test (psa) <1% 80 $551.74
90714 <1% 25 $535.98
82550 <1% 387 $527.13
82948 <1% 3,943 $523.34
86592 <1% 180 $511.42
83605 <1% 1,774 $502.42
85379 <1% 1,129 $469.96
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 15 $463.35
86376 <1% 38 $461.91
86880 <1% 25 $457.88
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 1,257 $451.59
J2704 Injection, propofol, 10 mg <1% 3,106 $428.18
J7030 Infusion, normal saline solution , 1000 cc <1% 5,035 $426.22
87040 <1% 1,688 $424.07
87070 <1% 556 $378.82
73110 <1% 309 $371.97
J1170 Injection, hydromorphone, up to 4 mg <1% 2,634 $367.98
90713 <1% 13 $326.30
90632 <1% 12 $288.92
84156 <1% 131 $271.69
85007 <1% 589 $248.91
90472 Immunization administration, each additional vaccine (list separately) <1% 934 $226.93
84100 <1% 65 $209.08
84480 <1% 39 $191.26
93016 <1% 12 $181.50
74019 <1% 99 $173.98
83021 <1% 13 $173.60
86800 <1% 13 $153.83
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 6,162 $152.81
83002 <1% 12 $148.53
93018 <1% 12 $148.50
81002 <1% 1,296 $148.22
72040 <1% 24 $144.61
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 1,365 $143.59
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 125 $139.31
82565 <1% 55 $122.61
84460 <1% 53 $114.14
84703 <1% 1,076 $101.64
J7050 Infusion, normal saline solution, 250 cc <1% 629 $100.06
82310 <1% 56 $98.96
87205 <1% 267 $96.87
84520 <1% 54 $93.78
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 2,522 $93.43
87081 <1% 753 $92.88
84481 <1% 13 $90.00
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 6,299 $81.04
A9270 Non-covered item or service <1% 14,414 $74.95
J3010 Injection, fentanyl citrate, 0.1 mg <1% 2,015 $69.64
82248 <1% 15 $66.30
J0690 Injection, cefazolin sodium, 500 mg <1% 676 $62.29
G0008 Administration of influenza virus vaccine <1% 17 $58.85
84436 <1% 13 $55.88
90460 Immunization administration through 18 years of age via any route, first or only component <1% 414 $50.00
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 1,624 $35.51
73080 <1% 30 $33.76
80320 <1% 367 $30.15
71101 <1% 13 $26.04
J2270 Injection, morphine sulfate, up to 10 mg <1% 776 $25.14
J1010 Injection, methylprednisolone acetate, 1 mg <1% 75 $19.48
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 151 $18.09
81015 <1% 182 $17.76
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 1,162 $16.35
85018 <1% 124 $12.12
73090 <1% 14 $12.12
82947 <1% 14 $11.79
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg <1% 204 $11.72
80355 <1% 262 $11.54
80369 <1% 261 $10.68
85014 <1% 122 $10.10
73590 <1% 12 $10.10
86308 <1% 13 $9.56
87075 <1% 27 $9.47
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 880 $8.46
J0780 Injection, prochlorperazine, up to 10 mg <1% 212 $7.62
J1956 Injection, levofloxacin, 250 mg <1% 211 $7.30
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg <1% 360 $6.83
J3490 Unclassified drugs <1% 325 $5.83
87802 <1% 204 $5.75
C9113 Injection, pantoprazole sodium, per vial <1% 192 $5.04
82040 <1% 12 $4.95
J3475 Injection, magnesium sulfate, per 500 mg <1% 76 $4.68
J1644 Injection, heparin sodium, per 1000 units <1% 38 $4.18
J1650 Injection, enoxaparin sodium, 10 mg <1% 275 $2.16
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg <1% 120 $1.17
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 603 $1.03
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% 59 $0.74
J2060 Injection, lorazepam, 2 mg <1% 255 $0.68
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 0% 86 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 0% 48 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 0% 94 $0.00
99152 0% 39 $0.00
82010 0% 42 $0.00
80179 0% 13 $0.00
80354 0% 17 $0.00
J1171 Injection, hydromorphone, 0.1 mg 0% 55 $0.00
93041 0% 15 $0.00
J1040 Injection, methylprednisolone acetate, 80 mg 0% 237 $0.00
96376 0% 1,228 $0.00
80368 0% 14 $0.00
80329 0% 27 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 0% 14 $0.00
80358 0% 12 $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 officialMACHOLZ, DAVID (CFO)
Same official

Other billing entities under MACHOLZ, DAVID

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.