Hospital
Essentia Health Virginia, LLC
Essentia Health Virginia, LLC was paid $12.89M by Medicaid between Jan 2018 and Dec 2024, across 109 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 55% of everything it billed.
33Billing provider infoESSENTIA HEALTH VIRGINIA, LLC
VIRGINIA, MN 55792
VIRGINIA, MN 55792
33aNPI1083617120assigned 05/23/2005
33bProvider typeGeneral Acute Care Hospital
28Total paid$12.89M
24GClaims220,292
24DCodes billed109
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Minnesota
Rank by total paid#18 of 36
Median peer was paid$11.46M
This provider vs. median1.1×
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 | 28,862 | $669K | |
| 2019 | 30,840 | $1.94M | |
| 2020 | 26,588 | $1.55M | |
| 2021 | 37,024 | $2.09M | |
| 2022 | 36,535 | $2.36M | |
| 2023 | 36,588 | $2.56M | |
| 2024incomplete | 23,855 | $1.72M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 55% | 88,757 | 77,066 | $7.07M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 15% | 10,720 | 9,225 | $1.87M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 12% | 13,208 | 11,350 | $1.59M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 6.0% | 9,835 | 8,564 | $778K |
| 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 | 3.6% | 7,747 | 4,178 | $460K |
| 36415 | Collection of venous blood by venipuncture | 1.4% | 30,959 | 27,676 | $177K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 1,194 | 1,165 | $107K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 856 | 806 | $95K |
| 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% | 4,788 | 2,822 | $69K |
| 80053 | Comprehensive metabolic panel | <1% | 5,470 | 4,960 | $65K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 511 | 489 | $65K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 3,416 | 3,052 | $54K |
97 more codes
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 1,537 | $47K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 848 | $39K |
| 71045 | Radiologic examination, chest; single view | <1% | 512 | $25K |
| 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% | 1,170 | $25K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 840 | $21K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 6,364 | $19K |
| 81514 | <1% | 81 | $18K | |
| 0001A | <1% | 665 | $16K | |
| 0002A | <1% | 613 | $16K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 363 | $15K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 796 | $15K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 1,220 | $14K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 1,222 | $14K |
| 85027 | <1% | 3,654 | $14K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,884 | $14K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 122 | $13K |
| 20610 | <1% | 57 | $13K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 1,712 | $12K |
| 94060 | <1% | 62 | $12K | |
| 87631 | <1% | 322 | $10K | |
| 91320 | <1% | 133 | $8K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 195 | $7K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 42 | $6K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 33 | $6K |
| Q3014 | Telehealth originating site facility fee | <1% | 233 | $6K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 431 | $5K |
| 87510 | <1% | 1,165 | $4K | |
| 85610 | <1% | 1,785 | $4K | |
| 90480 | <1% | 150 | $4K | |
| 83605 | <1% | 1,136 | $4K | |
| 97810 | <1% | 132 | $4K | |
| 80061 | Lipid panel | <1% | 352 | $4K |
| 87660 | <1% | 1,165 | $4K | |
| 92557 | <1% | 44 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 303 | $3K |
| 90686 | <1% | 279 | $3K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 28 | $3K |
| 87480 | <1% | 1,165 | $3K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 503 | $3K |
| 84703 | <1% | 438 | $3K | |
| 0004A | <1% | 121 | $3K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 89 | $2K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 144 | $2K |
| 0352U | <1% | 87 | $2K | |
| 83735 | <1% | 1,236 | $2K | |
| 92567 | <1% | 350 | $2K | |
| 31575 | <1% | 12 | $2K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 167 | $1K |
| 11721 | <1% | 92 | $1K | |
| J2704 | Injection, propofol, 10 mg | <1% | 669 | $1K |
| 97811 | <1% | 136 | $1K | |
| 0124A | <1% | 38 | $1K | |
| 0072A | <1% | 30 | $961.20 | |
| 73630 | <1% | 88 | $947.35 | |
| 94726 | <1% | 47 | $800.27 | |
| 82248 | <1% | 531 | $797.44 | |
| 94729 | <1% | 48 | $734.74 | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 528 | $726.92 |
| 84484 | <1% | 305 | $710.45 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 772 | $661.63 |
| 0071A | <1% | 18 | $592.82 | |
| 82077 | <1% | 446 | $489.87 | |
| 86140 | <1% | 431 | $463.10 | |
| 0064A | <1% | 18 | $461.53 | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 28 | $428.46 |
| 86780 | <1% | 41 | $383.72 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 103 | $377.06 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 527 | $369.41 |
| 87081 | <1% | 138 | $326.45 | |
| 83690 | <1% | 134 | $314.62 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 167 | $308.06 |
| 88142 | <1% | 31 | $277.85 | |
| 81003 | <1% | 100 | $223.24 | |
| 0003A | <1% | 13 | $188.11 | |
| 81001 | <1% | 165 | $179.43 | |
| 85018 | <1% | 151 | $162.73 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 140 | $154.90 |
| 0031A | <1% | 18 | $133.83 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 111 | $133.61 |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 13 | $107.87 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 181 | $104.19 |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 15 | $87.10 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 41 | $54.38 |
| 85730 | <1% | 74 | $54.36 | |
| S0028 | Injection, famotidine, 20 mg | <1% | 14 | $48.99 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 94 | $37.24 |
| 82962 | <1% | 12 | $14.76 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 61 | $10.81 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 27 | $5.30 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 23 | $5.16 |
| 87086 | Culture, bacterial; quantitative colony count, urine | 0% | 27 | $0.00 |
| A9270 | Non-covered item or service | 0% | 132 | $0.00 |
| 85379 | 0% | 12 | $0.00 | |
| 80143 | 0% | 27 | $0.00 | |
| 84100 | 0% | 14 | $0.00 | |
| 80179 | 0% | 26 | $0.00 | |
| 84145 | 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 officialSTONE, SAMUEL (COO)
Parent organizationST. MARY'S DULUTH CLINIC HEALTH SYSTEM
| Provider | Location | Paid |
|---|---|---|
| Essentia Health Virginia, LLC | International Falls, MN | $5.65M |
| Essentia Health Virginia, LLC | Ely, MN | $3.18M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.