Clinic
Grand River Hospital District
Grand River Hospital District was paid $13.96M by Medicaid between Jan 2018 and Dec 2024, across 50 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
33Billing provider infoGRAND RIVER HOSPITAL DISTRICT
RIFLE, CO 81650
RIFLE, CO 81650
33aNPI1124074042assigned 05/25/2006
33bProvider typePrimary Care Clinic/Center
28Total paid$13.96M
24GClaims81,096
24DCodes billed50
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Colorado
Rank by total paid#1 of 101
Median peer was paid$140K
This provider vs. median100×
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 | 11,359 | $1.48M | |
| 2019 | 10,786 | $1.46M | |
| 2020 | 10,423 | $1.23M | |
| 2021 | 9,512 | $1.42M | |
| 2022 | 10,632 | $2.19M | |
| 2023 | 16,667 | $3.45M | |
| 2024incomplete | 11,717 | $2.73M |
Box 24 · Service lines
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 | 46% | 24,876 | 21,265 | $6.46M |
| 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 | 24% | 18,969 | 15,289 | $3.39M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 7.7% | 6,352 | 3,464 | $1.08M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.9% | 2,244 | 1,928 | $689K |
| 96127 | 3.6% | 2,686 | 2,256 | $496K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.2% | 3,523 | 2,721 | $448K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.2% | 1,353 | 1,291 | $311K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.9% | 790 | 764 | $264K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.4% | 582 | 557 | $199K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 415 | 400 | $121K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 424 | 251 | $118K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 271 | 262 | $91K |
38 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 347 | $75K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 513 | $50K |
| 99173 | <1% | 84 | $34K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 76 | $26K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 115 | $22K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 7,325 | $21K |
| 90686 | <1% | 3,141 | $11K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 54 | $11K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 40 | $6K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 132 | $6K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 157 | $5K |
| 99174 | <1% | 101 | $5K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 3,017 | $4K |
| 11721 | <1% | 245 | $4K | |
| 99205 | Prolong outpt/office vis | <1% | 13 | $4K |
| 99284 | Emergency room visit (serious) | <1% | 42 | $4K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 79 | $3K |
| 99177 | <1% | 26 | $3K | |
| 99283 | Emergency room visit (moderate) | <1% | 60 | $3K |
| 90651 | <1% | 162 | $3K | |
| 90670 | <1% | 401 | $3K | |
| 90734 | <1% | 84 | $858.01 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 492 | $456.90 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 22 | $373.04 |
| D1206 | Topical application of fluoride varnish | <1% | 434 | $276.04 |
| 90648 | <1% | 419 | $201.64 | |
| 90633 | <1% | 43 | $190.95 | |
| 90863 | <1% | 66 | $184.76 | |
| 90723 | <1% | 154 | $183.18 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 130 | $146.00 |
| 90685 | <1% | 119 | $134.51 | |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 16 | $58.32 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 221 | $0.00 |
| 90677 | 0% | 75 | $0.00 | |
| 90480 | 0% | 43 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 118 | $0.00 |
| 91321 | 0% | 33 | $0.00 | |
| 90681 | 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 officialCOOMBS, JAMES (CEO)
Parent organizationGRAND RIVER HOSPITAL DISTRICT
| Provider | Location | Paid |
|---|---|---|
| Grand River Hospital District | Parachute, CO | $4.88M |
| Grand River Hospital District | Rifle, CO | $3.63M |
| Grand River Hospital District | Rifle, CO | $661K |
| Southern Idaho Ophthalmology PLLC | Twin Falls, ID | $55K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.