Saint Alphonsus Medical Center- Ontario INC
Saint Alphonsus Medical Center- Ontario INC was paid $753K by Medicaid between Jan 2018 and Nov 2024, across 41 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 52% of everything it billed.
ONTARIO, OR 97914
Next to other Obstetrics & Gynecology Physician providers in Oregon
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 5,536 | $192K | |
| 2019 | 3,835 | $105K | |
| 2020 | 2,690 | $75K | |
| 2021 | 3,203 | $97K | |
| 2022 | 3,676 | $118K | |
| 2023 | 3,400 | $102K | |
| 2024incomplete | 2,191 | $63K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 52% | 11,445 | 8,846 | $391K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 18% | 2,003 | 1,927 | $135K |
| 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 | 13% | 3,978 | 3,665 | $97K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 3.4% | 255 | 239 | $26K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 3.1% | 922 | 490 | $23K |
| 99460 | 2.7% | 308 | 265 | $20K | |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.0% | 288 | 248 | $15K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 370 | 326 | $10K |
| 20610 | <1% | 186 | 168 | $7K | |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | <1% | 37 | 37 | $5K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 833 | 749 | $3K |
| 11721 | <1% | 325 | 304 | $3K |
29 more codes
| 36415 | Collection of venous blood by venipuncture | <1% | 1,159 | $2K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 107 | $2K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 40 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 41 | $2K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 44 | $1K |
| 81025 | <1% | 216 | $1K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 16 | $1K |
| 0011A | <1% | 31 | $880.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 72 | $728.66 |
| 0002A | <1% | 30 | $720.00 | |
| 87428 | <1% | 32 | $599.46 | |
| 0012A | <1% | 15 | $400.00 | |
| 0001A | <1% | 18 | $360.00 | |
| 73560 | <1% | 13 | $189.56 | |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 29 | $180.95 |
| 90715 | <1% | 25 | $142.16 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | $79.86 |
| 99153 | Mod sedat endo service >5yrs | <1% | 28 | $43.35 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 17 | $38.05 |
| 81003 | <1% | 16 | $23.08 | |
| 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% | 14 | $14.52 |
| 3078F | 0% | 601 | $0.00 | |
| 91300 | 0% | 79 | $0.00 | |
| 3074F | 0% | 651 | $0.00 | |
| 3075F | 0% | 54 | $0.00 | |
| 3079F | 0% | 169 | $0.00 | |
| 3044F | 0% | 25 | $0.00 | |
| 99024 | 0% | 13 | $0.00 | |
| 91301 | 0% | 13 | $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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Saint Alphonsus Regional Medical Center INC | Caldwell, ID | $32.60M |
| Saint Alphonsus Regional Medical Center INC | Caldwell, ID | $9.83M |
| Saint Alphonsus Regional Medical Center INC | Boise, ID | $5.08M |
| Saint Alphonsus Medical Center Baker City, INC | Baker City, OR | $4.31M |
| Saint Alphonsus Regional Medical Center INC | Boise, ID | $4.17M |
| Saint Alphonsus Medical Center- Ontario INC | Ontario, OR | $3.67M |
| Saint Alphonsus Regional Medical Center INC | Boise, ID | $1.92M |
| Saint Alphonsus Medical Center- Ontario INC | Fruitland, ID | $856K |
| ST Alphonsus Professional Medical Services LLC | Boise, ID | $408K |
| Saint Alphonsus Medical Center Baker City, INC | Baker City, OR | $342K |
| Saint Alphonsus Regional Medical Center INC | Boise, ID | $295K |
| Saint Alphonsus Medical Center Baker City, INC. | Baker City, OR | $223K |
| Saint Alphonsus Medical Center- Ontario INC | Ontario, OR | $6K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.