Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WI › SUPERIOR › ST. MARY'S HOSPITAL OF SUPERIOR

ST. MARY'S HOSPITAL OF SUPERIOR

NPI: 1083657886 · SUPERIOR, WI 54880 · Emergency Care Clinic/Center · NPI assigned 06/13/2006

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

Authorized official BOREN, KEVIN controls 20+ related entities in our dataset. Read more

$13.36M
Total Medicaid Paid
341,655
Total Claims
243,110
Beneficiaries
188
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOREN, KEVIN (VP OF FINANCE)
Parent OrganizationESSENTIA HEALTH
NPI Enumeration Date06/13/2006

Related Entities

Other providers sharing the same authorized official: BOREN, KEVIN

ProviderCityStateTotal Paid
THE DULUTH CLINIC, LTD DULUTH MN $51.60M
ST. JOSEPH'S MEDICAL CENTER BRAINERD MN $41.35M
SMDC MEDICAL CENTER DULUTH MN $35.51M
ST MARYS MEDICAL CENTER DULUTH MN $20.98M
ST JOSEPH'S MEDICAL CENTER BAXTER MN $7.23M
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM DULUTH MN $4.97M
DEER RIVER HEALTHCARE CENTER, INC. DEER RIVER MN $4.57M
ST. MARY'S MEDICAL CENTER DULUTH MN $3.66M
ST. JOSEPH'S MEDICAL CENTER BRAINERD MN $3.25M
THE DULUTH CLINIC, LTD VIRGINIA MN $2.82M
THE DULUTH CLINIC, LTD DULUTH MN $2.66M
NORTHERN PINES MEDICAL CENTER AURORA MN $1.72M
ST. MARY'S HOSPITAL OF SUPERIOR SUPERIOR WI $1.65M
POLINSKY MEDICAL REHABILITATION CENTER DULUTH MN $1.61M
PINE MEDICAL CENTER SANDSTONE MN $1.32M
THE DULUTH CLINIC, LTD HERMANTOWN MN $1.30M
THE DULUTH CLINIC LTD GRAND RAPIDS MN $1.18M
THE DULUTH CLINIC, LTD DULUTH MN $1.13M
THE DULUTH CLINIC, LTD ASHLAND WI $1.07M
ST MARY'S HOSPITAL OF SUPERIOR SPOONER WI $1.05M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 45,614 $1.57M
2019 45,932 $1.82M
2020 38,704 $1.63M
2021 52,294 $1.89M
2022 53,835 $2.36M
2023 59,639 $2.19M
2024 45,637 $1.90M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99283 Emergency department visit for the evaluation and management, moderate severity 17,070 13,755 $3.09M
99284 Emergency department visit for the evaluation and management, high severity 12,983 9,657 $2.04M
96361 Intravenous infusion, hydration; each additional hour 3,653 2,881 $1.63M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 8,253 5,809 $1.25M
74177 Computed tomography, abdomen and pelvis; with contrast material 2,193 1,900 $578K
99282 Emergency department visit for the evaluation and management, low to moderate severity 3,738 3,213 $556K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 2,581 1,861 $520K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 19,027 13,460 $475K
70450 Computed tomography, head or brain; without contrast material 1,687 1,460 $445K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 8,860 3,350 $264K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 621 399 $201K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 22,860 12,301 $180K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 1,287 920 $163K
71046 Radiologic examination, chest; 2 views 4,068 3,581 $114K
97530 Therapeutic activities, direct patient contact, each 15 minutes 2,365 964 $101K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 2,229 1,945 $83K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 11,081 6,026 $72K
20610 2,820 1,042 $70K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2,068 1,699 $67K
80053 Comprehensive metabolic panel 9,955 8,130 $55K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 152 142 $55K
76705 Ultrasound, abdominal, real time with image documentation; limited 482 425 $55K
71275 Computed tomographic angiography, chest, with contrast material 172 134 $53K
77067 Screening mammography, bilateral, including computer-aided detection 910 817 $52K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,693 1,558 $52K
73630 1,793 1,467 $52K
97161 1,216 1,006 $47K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 10,774 8,682 $45K
87631 512 455 $43K
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 678 584 $41K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 170 138 $40K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1,946 723 $39K
73562 1,145 938 $38K
80048 Basic metabolic panel (calcium, ionized) 8,800 7,167 $37K
74176 Computed tomography, abdomen and pelvis; without contrast material 134 116 $34K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 487 445 $33K
73030 1,034 868 $31K
99215 Prolong outpt/office vis 3,148 1,869 $30K
84484 4,893 3,536 $28K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,097 932 $26K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 7,578 6,309 $22K
83605 3,713 2,842 $21K
99281 Emergency department visit for the evaluation and management, self-limited or minor 96 85 $19K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 660 306 $18K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 4,083 3,058 $17K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 927 801 $16K
72100 412 350 $16K
73130 611 481 $15K
84703 2,347 2,000 $15K
11721 1,454 653 $15K
86140 4,865 4,018 $14K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 24 14 $14K
73610 597 510 $14K
85027 5,970 5,078 $13K
73502 462 379 $13K
84443 Thyroid stimulating hormone (TSH) 3,221 2,793 $12K
72125 Computed tomography, cervical spine; without contrast material 154 140 $12K
83690 2,807 2,341 $12K
81001 4,945 4,161 $12K
77063 Screening digital breast tomosynthesis, bilateral 187 174 $12K
83735 3,899 3,113 $11K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 759 587 $11K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 465 229 $11K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 279 110 $11K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 4,038 3,325 $10K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 60 50 $10K
83880 896 768 $10K
73110 345 288 $10K
71045 Radiologic examination, chest; single view 3,000 2,579 $10K
87040 1,670 805 $8K
74018 208 185 $8K
87086 Culture, bacterial; quantitative colony count, urine 2,189 1,906 $8K
85379 1,376 1,183 $8K
82077 1,041 854 $8K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 289 73 $6K
82962 5,241 1,320 $6K
36415 Collection of venous blood by venipuncture 22,941 16,855 $6K
85610 4,800 3,063 $5K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 349 323 $5K
71260 Computed tomography, thorax, diagnostic; with contrast material 16 13 $5K
84145 426 364 $4K
81003 2,648 2,301 $4K
87632 35 30 $4K
93971 39 38 $4K
87077 1,327 969 $4K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 178 128 $4K
83036 Hemoglobin; glycosylated (A1C) 2,923 2,508 $4K
80061 Lipid panel 2,069 1,784 $4K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 418 187 $4K
Q3014 Telehealth originating site facility fee 1,283 965 $3K
87186 1,104 862 $3K
99443 191 166 $3K
90715 205 168 $3K
0240U 169 115 $3K
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 375 305 $3K
0202U Oncology (prostate), multianalyte, gene expression profiling 60 56 $2K
90834 Psychotherapy, 45 minutes with patient 123 50 $2K
97162 56 48 $2K
0011A 124 98 $2K
82248 857 746 $2K
87081 146 135 $2K
90686 785 643 $2K
87420 35 33 $2K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,376 1,104 $2K
99442 160 144 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 913 698 $1K
91320 287 265 $1K
76830 Ultrasound, transvaginal 15 12 $1K
99309 Subsequent nursing facility care, per day, low to moderate complexity 128 98 $1K
0012A 66 54 $1K
88305 Level IV - Surgical pathology, gross and microscopic examination 582 236 $1K
96375 Therapeutic injection; each additional sequential IV push 3,702 2,999 $1K
92015 Determination of refractive state 723 615 $1K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 45 37 $903.29
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 45 37 $823.95
99310 Prolong nursin fac eval 15m 34 29 $809.92
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 3,710 3,152 $742.89
G0378 Hospital observation service, per hour 89 61 $576.57
J1885 Injection, ketorolac tromethamine, per 15 mg 3,518 2,876 $567.55
88142 28 26 $534.24
99490 Ccm add 20min 261 246 $511.05
90480 287 265 $491.09
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 480 379 $474.01
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 36 28 $445.63
91301 60 46 $414.93
97035 41 13 $390.54
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 208 169 $378.43
0071A 17 15 $374.08
J2704 Injection, propofol, 10 mg 907 744 $295.77
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 95 76 $267.26
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 3,926 2,422 $245.36
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 175 150 $244.54
80047 39 35 $235.55
0001A 26 14 $230.33
87510 14 13 $187.23
87480 14 13 $187.23
87660 14 13 $187.23
82043 115 97 $183.06
80143 18 12 $180.12
J7030 Infusion, normal saline solution , 1000 cc 4,295 3,344 $169.95
90656 85 82 $167.51
90694 124 88 $167.31
J2405 Injection, ondansetron hydrochloride, per 1 mg 2,578 2,119 $161.22
84100 101 78 $150.81
80179 17 12 $150.00
82728 14 12 $125.99
0064A 160 129 $122.41
90677 16 12 $104.55
J0696 Injection, ceftriaxone sodium, per 250 mg 335 245 $103.54
0352U 12 12 $100.56
85652 89 75 $89.96
G0008 Administration of influenza virus vaccine 1,227 1,083 $85.16
96127 39 27 $82.08
90662 418 361 $81.26
0124A 192 155 $77.66
J1100 Injection, dexamethasone sodium phosphate, 1 mg 364 315 $65.39
82607 29 24 $64.94
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 62 53 $55.47
99406 43 17 $46.64
90653 64 59 $39.13
J3010 Injection, fentanyl citrate, 0.1 mg 303 240 $38.75
96376 143 103 $34.43
J7120 Ringers lactate infusion, up to 1000 cc 445 312 $31.04
82565 51 40 $30.75
82550 15 13 $29.88
G2058 Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)). 19 15 $20.61
84439 13 12 $18.64
0054A 37 32 $9.44
99497 23 22 $5.64
J3475 Injection, magnesium sulfate, per 500 mg 130 104 $3.61
85018 42 37 $3.34
J1170 Injection, hydromorphone, up to 4 mg 512 369 $2.29
A9270 Non-covered item or service 10,906 1,960 $1.68
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 81 53 $0.52
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) 725 621 $0.46
J3490 Unclassified drugs 43 39 $0.43
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 60 56 $0.38
G0009 Administration of pneumococcal vaccine 32 31 $0.00
90732 13 12 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 39 34 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 12 12 $0.00
J0690 Injection, cefazolin sodium, 500 mg 14 12 $0.00
91306 18 12 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 18 14 $0.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 198 163 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 31 28 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 115 80 $0.00
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 14 13 $0.00