Hospital
Monroe Medical Foundation, INC.
Monroe Medical Foundation, INC. was paid $7.31M by Medicaid between Jan 2018 and Nov 2024, across 98 billing codes. Its largest line is 96372, Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular — 14% of everything it billed.
33Billing provider infoMONROE MEDICAL FOUNDATION, INC.
TOMPKINSVILLE, KY 42167
TOMPKINSVILLE, KY 42167
33aNPI1053499350assigned 11/02/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$7.31M
24GClaims166,387
24DCodes billed98
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in Kentucky
Rank by total paid#31 of 36
Median peer was paid$36.08M
This provider vs. median0.2×
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
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
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 25,614 | $1.17M | |
| 2019 | 25,227 | $1.22M | |
| 2020 | 19,458 | $894K | |
| 2021 | 25,056 | $1.04M | |
| 2022 | 22,506 | $1.04M | |
| 2023 | 29,992 | $1.22M | |
| 2024incomplete | 18,534 | $725K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 14% | 8,835 | 5,679 | $1.01M |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 9.6% | 1,624 | 1,284 | $704K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 8.5% | 8,250 | 7,214 | $620K |
| G0378 | Hospital observation service, per hour | 8.3% | 2,671 | 2,166 | $606K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 5.8% | 3,457 | 2,802 | $426K |
| 96361 | Intravenous infusion, hydration; each additional hour | 5.8% | 2,392 | 1,109 | $424K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 4.7% | 8,940 | 2,107 | $347K |
| G0379 | Direct admission of patient for hospital observation care | 3.7% | 2,699 | 1,521 | $268K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 3.5% | 3,301 | 2,987 | $256K |
| 70450 | Computed tomography, head or brain; without contrast material | 3.0% | 1,326 | 951 | $220K |
| 71046 | Radiologic examination, chest; 2 views | 2.8% | 3,607 | 2,826 | $205K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2.7% | 356 | 264 | $198K |
86 more codes
| 99285 | Emergency room visit (most serious) | 2.7% | 2,178 | $196K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 2.3% | 3,892 | $169K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 2.2% | 3,519 | $160K |
| 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 | 1.8% | 1,985 | $129K |
| 71045 | Radiologic examination, chest; single view | 1.4% | 3,104 | $103K |
| 80053 | Comprehensive metabolic panel | 1.3% | 22,591 | $98K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 1.3% | 1,724 | $94K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.2% | 12,569 | $85K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.1% | 1,532 | $78K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 2,035 | $60K |
| 36415 | Collection of venous blood by venipuncture | <1% | 14,722 | $54K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 2,654 | $50K |
| 97161 | <1% | 1,323 | $48K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 1,832 | $47K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 1,163 | $46K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 113 | $38K |
| 97035 | <1% | 1,653 | $36K | |
| 84484 | <1% | 2,172 | $33K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 2,227 | $31K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 520 | $28K |
| 80061 | Lipid panel | <1% | 2,812 | $28K |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | <1% | 448 | $28K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,204 | $27K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 497 | $24K |
| 94760 | <1% | 1,592 | $23K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 434 | $18K |
| 87581 | <1% | 598 | $17K | |
| 96376 | <1% | 427 | $17K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 3,192 | $17K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 274 | $17K |
| 81001 | <1% | 4,602 | $16K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 194 | $11K |
| 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% | 1,405 | $11K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | <1% | 269 | $10K |
| 84480 | <1% | 825 | $10K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,396 | $10K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 159 | $9K |
| 83690 | <1% | 1,241 | $9K | |
| A0425 | Ground mileage, per statute mile | <1% | 2,424 | $9K |
| 74022 | <1% | 82 | $9K | |
| 73564 | <1% | 108 | $8K | |
| 83735 | <1% | 1,058 | $7K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 858 | $7K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 12 | $7K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | <1% | 108 | $7K |
| 82150 | <1% | 1,171 | $7K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 40 | $6K |
| 73630 | <1% | 70 | $5K | |
| 84436 | <1% | 883 | $5K | |
| 82607 | <1% | 468 | $5K | |
| 83880 | <1% | 151 | $4K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 341 | $4K |
| 80305 | <1% | 407 | $4K | |
| 85379 | <1% | 426 | $4K | |
| 84439 | <1% | 462 | $4K | |
| 85610 | <1% | 1,044 | $4K | |
| 82962 | <1% | 700 | $3K | |
| 82746 | <1% | 266 | $3K | |
| 73610 | <1% | 41 | $3K | |
| 85730 | <1% | 646 | $3K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 119 | $3K |
| 72110 | <1% | 35 | $2K | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | <1% | 224 | $2K |
| 93017 | <1% | 14 | $2K | |
| 84702 | <1% | 95 | $2K | |
| 82728 | <1% | 127 | $1K | |
| 87070 | <1% | 171 | $1K | |
| 83540 | <1% | 204 | $1K | |
| 73110 | <1% | 13 | $1K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 35 | $758.98 |
| 73030 | <1% | 21 | $688.27 | |
| 84703 | <1% | 85 | $667.97 | |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | <1% | 153 | $666.13 |
| 87040 | <1% | 62 | $643.90 | |
| 86140 | <1% | 155 | $636.19 | |
| 82550 | <1% | 66 | $539.83 | |
| 93041 | <1% | 36 | $537.08 | |
| 83605 | <1% | 58 | $466.90 | |
| 84466 | <1% | 33 | $369.43 | |
| 86803 | <1% | 32 | $336.24 | |
| 82553 | <1% | 18 | $320.35 | |
| 85652 | <1% | 93 | $216.12 | |
| 83615 | <1% | 19 | $173.67 | |
| 82248 | <1% | 33 | $119.42 | |
| 85045 | <1% | 33 | $115.57 | |
| A0427 | Emergency ambulance ride, advanced life support | <1% | 152 | $83.48 |
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 officialRICH-MCLERRAN, ANDREA (CEO)
| Provider | Location | Paid |
|---|---|---|
| Monroe Medical Foundation, INC. | Tompkinsville, KY | $1.30M |
| Monroe Medical Foundation, INC. | Tompkinsville, KY | $632K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.