Clinic
ST. Mary's Hospital of Superior
ST. Mary's Hospital of Superior was paid $13.36M by Medicaid between Jan 2018 and Dec 2024, across 188 billing codes. Its largest line is 99283, emergency room visit (moderate) — 23% of everything it billed.
33Billing provider infoST. MARY'S HOSPITAL OF SUPERIOR
SUPERIOR, WI 54880
SUPERIOR, WI 54880
33aNPI1083657886assigned 06/13/2006
33bProvider typeEmergency Care Clinic/Center
28Total paid$13.36M
24GClaims341,655
24DCodes billed188
24AFirst – last monthJan 2018 – Dec 2024
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official BOREN, KEVIN controls 20+ related entities in our dataset. Read more
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 | 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 | |
| 2024incomplete | 45,637 | $1.90M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 23% | 17,070 | 13,755 | $3.09M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 15% | 12,983 | 9,657 | $2.04M |
| 96361 | Intravenous infusion, hydration; each additional hour | 12% | 3,653 | 2,881 | $1.63M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 9.4% | 8,253 | 5,809 | $1.25M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 4.3% | 2,193 | 1,900 | $578K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 4.2% | 3,738 | 3,213 | $556K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 3.9% | 2,581 | 1,861 | $520K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 3.6% | 19,027 | 13,460 | $475K |
| 70450 | Computed tomography, head or brain; without contrast material | 3.3% | 1,687 | 1,460 | $445K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 2.0% | 8,860 | 3,350 | $264K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 1.5% | 621 | 399 | $201K |
| 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 | 1.3% | 22,860 | 12,301 | $180K |
176 more codes
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 1.2% | 1,287 | $163K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 4,068 | $114K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 2,365 | $101K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 2,229 | $83K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 11,081 | $72K |
| 20610 | <1% | 2,820 | $70K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 2,068 | $67K |
| 80053 | Comprehensive metabolic panel | <1% | 9,955 | $55K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 152 | $55K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 482 | $55K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 172 | $53K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 910 | $52K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,693 | $52K |
| 73630 | <1% | 1,793 | $52K | |
| 97161 | <1% | 1,216 | $47K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 10,774 | $45K |
| 87631 | <1% | 512 | $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 | <1% | 678 | $41K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 170 | $40K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 1,946 | $39K |
| 73562 | <1% | 1,145 | $38K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 8,800 | $37K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 134 | $34K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 487 | $33K |
| 73030 | <1% | 1,034 | $31K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 3,148 | $30K |
| 84484 | <1% | 4,893 | $28K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 1,097 | $26K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 7,578 | $22K |
| 83605 | <1% | 3,713 | $21K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 96 | $19K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 660 | $18K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,083 | $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 | <1% | 927 | $16K |
| 72100 | <1% | 412 | $16K | |
| 73130 | <1% | 611 | $15K | |
| 84703 | <1% | 2,347 | $15K | |
| 11721 | <1% | 1,454 | $15K | |
| 86140 | <1% | 4,865 | $14K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 24 | $14K |
| 73610 | <1% | 597 | $14K | |
| 85027 | <1% | 5,970 | $13K | |
| 73502 | <1% | 462 | $13K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 3,221 | $12K |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 154 | $12K |
| 83690 | <1% | 2,807 | $12K | |
| 81001 | <1% | 4,945 | $12K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 187 | $12K |
| 83735 | <1% | 3,899 | $11K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 759 | $11K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 465 | $11K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | <1% | 279 | $11K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 4,038 | $10K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 60 | $10K |
| 83880 | <1% | 896 | $10K | |
| 73110 | <1% | 345 | $10K | |
| 71045 | Radiologic examination, chest; single view | <1% | 3,000 | $10K |
| 87040 | <1% | 1,670 | $8K | |
| 74018 | <1% | 208 | $8K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 2,189 | $8K |
| 85379 | <1% | 1,376 | $8K | |
| 82077 | <1% | 1,041 | $8K | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 289 | $6K |
| 82962 | <1% | 5,241 | $6K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 22,941 | $6K |
| 85610 | <1% | 4,800 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 349 | $5K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 16 | $5K |
| 84145 | <1% | 426 | $4K | |
| 81003 | <1% | 2,648 | $4K | |
| 87632 | <1% | 35 | $4K | |
| 93971 | <1% | 39 | $4K | |
| 87077 | <1% | 1,327 | $4K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 178 | $4K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,923 | $4K |
| 80061 | Lipid panel | <1% | 2,069 | $4K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 418 | $4K |
| Q3014 | Telehealth originating site facility fee | <1% | 1,283 | $3K |
| 87186 | <1% | 1,104 | $3K | |
| 99443 | <1% | 191 | $3K | |
| 90715 | <1% | 205 | $3K | |
| 0240U | <1% | 169 | $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 | <1% | 375 | $3K |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | <1% | 60 | $2K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 123 | $2K |
| 97162 | <1% | 56 | $2K | |
| 0011A | <1% | 124 | $2K | |
| 82248 | <1% | 857 | $2K | |
| 87081 | <1% | 146 | $2K | |
| 90686 | <1% | 785 | $2K | |
| 87420 | <1% | 35 | $2K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 1,376 | $2K |
| 99442 | <1% | 160 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 913 | $1K |
| 91320 | <1% | 287 | $1K | |
| 76830 | Ultrasound, transvaginal | <1% | 15 | $1K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 128 | $1K |
| 0012A | <1% | 66 | $1K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 582 | $1K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 3,702 | $1K |
| 92015 | Determination of refractive state | <1% | 723 | $1K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 45 | $903.29 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 45 | $823.95 |
| 99310 | Prolong nursin fac eval 15m | <1% | 34 | $809.92 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 3,710 | $742.89 |
| G0378 | Hospital observation service, per hour | <1% | 89 | $576.57 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 3,518 | $567.55 |
| 88142 | <1% | 28 | $534.24 | |
| 99490 | Ccm add 20min | <1% | 261 | $511.05 |
| 90480 | <1% | 287 | $491.09 | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 480 | $474.01 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 36 | $445.63 |
| 91301 | <1% | 60 | $414.93 | |
| 97035 | <1% | 41 | $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) | <1% | 208 | $378.43 |
| 0071A | <1% | 17 | $374.08 | |
| J2704 | Injection, propofol, 10 mg | <1% | 907 | $295.77 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | <1% | 95 | $267.26 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 3,926 | $245.36 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 175 | $244.54 |
| 80047 | <1% | 39 | $235.55 | |
| 0001A | <1% | 26 | $230.33 | |
| 87510 | <1% | 14 | $187.23 | |
| 87480 | <1% | 14 | $187.23 | |
| 87660 | <1% | 14 | $187.23 | |
| 82043 | <1% | 115 | $183.06 | |
| 80143 | <1% | 18 | $180.12 | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 4,295 | $169.95 |
| 90656 | <1% | 85 | $167.51 | |
| 90694 | <1% | 124 | $167.31 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,578 | $161.22 |
| 84100 | <1% | 101 | $150.81 | |
| 80179 | <1% | 17 | $150.00 | |
| 82728 | <1% | 14 | $125.99 | |
| 0064A | <1% | 160 | $122.41 | |
| 90677 | <1% | 16 | $104.55 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 335 | $103.54 |
| 0352U | <1% | 12 | $100.56 | |
| 85652 | <1% | 89 | $89.96 | |
| G0008 | Administration of influenza virus vaccine | <1% | 1,227 | $85.16 |
| 96127 | <1% | 39 | $82.08 | |
| 90662 | <1% | 418 | $81.26 | |
| 0124A | <1% | 192 | $77.66 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 364 | $65.39 |
| 82607 | <1% | 29 | $64.94 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 62 | $55.47 |
| 99406 | <1% | 43 | $46.64 | |
| 90653 | <1% | 64 | $39.13 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 303 | $38.75 |
| 96376 | <1% | 143 | $34.43 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 445 | $31.04 |
| 82565 | <1% | 51 | $30.75 | |
| 82550 | <1% | 15 | $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)). | <1% | 19 | $20.61 |
| 84439 | <1% | 13 | $18.64 | |
| 0054A | <1% | 37 | $9.44 | |
| 99497 | <1% | 23 | $5.64 | |
| J3475 | Injection, magnesium sulfate, per 500 mg | <1% | 130 | $3.61 |
| 85018 | <1% | 42 | $3.34 | |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 512 | $2.29 |
| A9270 | Non-covered item or service | <1% | 10,906 | $1.68 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | <1% | 81 | $0.52 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | <1% | 725 | $0.46 |
| J3490 | Unclassified drugs | <1% | 43 | $0.43 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 60 | $0.38 |
| G0009 | Administration of pneumococcal vaccine | 0% | 32 | $0.00 |
| 90732 | 0% | 13 | $0.00 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 39 | $0.00 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 12 | $0.00 |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 14 | $0.00 |
| 91306 | 0% | 18 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 18 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 198 | $0.00 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 0% | 31 | $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 | 0% | 115 | $0.00 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 0% | 14 | $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 officialBOREN, KEVIN (VP OF FINANCE)
Parent organizationESSENTIA HEALTH
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.