Medicaid Provider Spending

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

COMMUNITY MERCY HEALTH PARTNERS

NPI: 1063066066 · URBANA, OH 43078 · Rural Health Clinic/Center · NPI assigned 07/29/2019

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

Authorized official RALSTON, KIMBERLY controls 20+ related entities in our dataset. Read more

$1.16M
Total Medicaid Paid
66,231
Total Claims
49,164
Beneficiaries
46
Codes Billed
2020-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialRALSTON, KIMBERLY (SYSTEM DIRECTOR)
NPI Enumeration Date07/29/2019

Related Entities

Other providers sharing the same authorized official: RALSTON, KIMBERLY

ProviderCityStateTotal Paid
BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC RICHMOND VA $83.03M
MARYVIEW HOSPITAL LLC PORTSMOUTH VA $75.03M
BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC RICHMOND VA $57.21M
BON SECOURS ST FRANCIS MEDICAL CENTER LLC MIDLOTHIAN VA $44.86M
MERCY HEALTH YOUNGSTOWN LLC WARREN OH $43.63M
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC MECHANICSVILLE VA $42.02M
MERCY HEALTH YOUNGSTOWN LLC YOUNGSTOWN OH $36.60M
MERCY HEALTH - FAIRFIELD HOSPITAL LLC FAIRFIELD OH $25.17M
MARY IMMACULATE HOSPITAL LLC NEWPORT NEWS VA $24.51M
ST FRANCIS HOSPITAL INC GREENVILLE SC $17.81M
NWO INTEGRATED LABORATORIES MERCY LLC TOLEDO OH $13.47M
HOSPICE OF THE VALLEY, INC. GIRARD OH $13.33M
MERCY HEALTH - TIFFIN HOSPITAL LLC TIFFIN OH $12.99M
MERCY HEALTH - DEFIANCE HOSPITAL LLC DEFIANCE OH $11.90M
BON SECOURS DEPAUL MEDICAL CENTER LLC NORFOLK VA $11.59M
COMMUNITY MERCY HEALTH PARTNERS URBANA OH $8.81M
MERCY HEALTH-ALLEN HOSPITAL LLC OBERLIN OH $8.61M
CHESAPEAKE HOSPITAL LLC KILMARNOCK VA $6.00M
MARYVIEW HOSPITAL, LLC SUFFOLK VA $3.48M
ROPER ST FRANCIS ANCILLARY SERVICES LADSON SC $3.33M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 9,140 $195K
2021 9,285 $226K
2022 15,868 $321K
2023 26,557 $321K
2024 5,381 $93K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 11,441 7,481 $321K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 11,801 9,544 $292K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,069 5,810 $243K
90460 Immunization administration through 18 years of age via any route, first or only component 7,552 3,550 $91K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,810 1,478 $56K
90837 Psychotherapy, 53 minutes with patient 1,092 604 $51K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 817 636 $22K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 659 525 $19K
90832 Psychotherapy, 30 minutes with patient 672 408 $17K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 433 332 $14K
90686 550 538 $7K
90670 708 532 $6K
90651 123 102 $4K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 56 54 $4K
90633 223 171 $3K
90734 132 101 $3K
90710 172 133 $970.75
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 59 56 $597.52
90674 304 224 $530.04
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 52 47 $449.96
36415 Collection of venous blood by venipuncture 403 319 $336.66
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 26 12 $286.66
85018 191 149 $199.71
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 71 43 $182.28
83036 Hemoglobin; glycosylated (A1C) 52 42 $125.39
90744 26 26 $115.00
90696 36 24 $111.38
90697 128 84 $62.50
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 36 27 $56.14
96160 13 13 $46.80
90698 18 17 $10.00
3017F 293 258 $0.00
1036F 2,210 1,869 $0.00
94760 15 15 $0.00
3074F 50 38 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 14 14 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 15 14 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 16 13 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 2,290 1,948 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 4,416 3,785 $0.00
4004F 487 434 $0.00
G8482 Influenza immunization administered or previously received 1,645 1,294 $0.00
G8484 Influenza immunization was not administered, reason not given 7,949 6,318 $0.00
3078F 57 42 $0.00
90681 37 28 $0.00
90715 12 12 $0.00