Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › WI › Portage › NPI 1124083894
Physician

Divine Savior Healthcare, INC.

Divine Savior Healthcare, INC. was paid $9.10M by Medicaid between Jan 2018 and Dec 2024, across 230 billing codes. Its largest line is 99284, emergency room visit (serious) — 8.0% of everything it billed.

33Billing provider infoDIVINE SAVIOR HEALTHCARE, INC.
PORTAGE, WI 53901
33aNPI1124083894assigned 04/18/2006
28Total paid$9.10M
24GClaims370,348
24DCodes billed230
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Family Medicine Physician providers in Wisconsin

Rank by total paid#5 of 359
Median peer was paid$4K
This provider vs. median2,340×

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.

Entity ProliferationAuthorized official PECK, LORI controls 12+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$100K$200K2018201920202021202220232024
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
YearClaimsPaid
201858,440$1.45M
201955,528$1.48M
202045,937$1.15M
202150,352$1.00M
202252,493$1.24M
202359,612$1.45M
2024incomplete47,986$1.33M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 8.0% 16,182 13,956 $725K
96361 Intravenous infusion, hydration; each additional hour 7.2% 5,750 4,545 $657K
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 7.2% 14,166 12,311 $651K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 6.4% 18,541 15,953 $587K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 4.8% 3,650 3,269 $435K
99282 Emergency department visit for the evaluation and management, low to moderate severity 3.4% 5,688 5,009 $305K
80053 Comprehensive metabolic panel 3.0% 16,106 13,149 $275K
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 2.9% 6,268 5,253 $260K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 2.6% 4,420 3,839 $234K
97530 Therapeutic activities, direct patient contact, each 15 minutes 2.4% 11,609 4,091 $220K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2.2% 4,031 3,388 $204K
G0381 Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 2.2% 3,438 3,121 $196K
218 more codes
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 2.1% 4,190 $195K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 2.1% 4,078 $188K
G0380 Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 2.1% 3,169 $188K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 1.9% 2,292 $177K
99214 Doctor's office visit, returning patient (more involved) 1.9% 3,867 $176K
G0382 Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 1.8% 2,975 $166K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1.7% 2,646 $153K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 1.6% 1,385 $144K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1.4% 18,490 $126K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1.4% 10,455 $124K
80306 1.3% 5,193 $120K
74177 Computed tomography, abdomen and pelvis; with contrast material 1.3% 1,936 $119K
70450 Computed tomography, head or brain; without contrast material 1.3% 2,341 $116K
99281 Emergency department visit for the evaluation and management, self-limited or minor 1.1% 1,683 $104K
80048 Basic metabolic panel (calcium, ionized) 1.1% 5,169 $96K
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% 3,164 $87K
84443 Thyroid stimulating hormone (TSH) <1% 4,747 $83K
A0427 Emergency ambulance ride, advanced life support <1% 1,251 $74K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder <1% 2,819 $73K
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% 1,201 $68K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 1,466 $66K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 1,691 $66K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 1,553 $65K
87086 Culture, bacterial; quantitative colony count, urine <1% 4,067 $61K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 1,736 $59K
81025 <1% 3,377 $59K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 616 $58K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 5,382 $56K
80061 Lipid panel <1% 3,431 $54K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 1,160 $54K
84484 <1% 5,379 $47K
83036 Hemoglobin; glycosylated (A1C) <1% 3,238 $46K
A0390 Als mileage (per mile) <1% 1,061 $45K
81001 <1% 10,305 $44K
84702 <1% 1,130 $41K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 576 $32K
G0378 Hospital observation service, per hour <1% 1,152 $32K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 435 $30K
73630 <1% 2,055 $28K
87480 <1% 1,127 $26K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 808 $25K
83690 <1% 4,124 $25K
82948 <1% 2,529 $23K
59025 Fetal non-stress test <1% 367 $22K
71046 Radiologic examination, chest; 2 views <1% 5,208 $21K
73110 <1% 1,095 $21K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 441 $19K
85610 <1% 2,510 $19K
87660 <1% 1,124 $18K
73030 <1% 1,334 $18K
87510 <1% 1,143 $18K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 331 $18K
99203 Doctor's office visit, new patient (routine) <1% 405 $18K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 427 $18K
84439 <1% 1,187 $15K
83880 <1% 771 $15K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 1,112 $15K
83735 <1% 2,949 $15K
87077 <1% 1,791 $15K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 190 $14K
83605 <1% 1,884 $14K
73564 <1% 781 $14K
73610 <1% 1,416 $13K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 513 $13K
87186 <1% 1,853 $13K
87634 <1% 283 $13K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 721 $12K
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% 1,172 $12K
77067 Screening mammography, bilateral, including computer-aided detection <1% 497 $12K
73130 <1% 884 $12K
A0429 Emergency ambulance ride, basic life support <1% 279 $12K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 267 $11K
76830 Ultrasound, transvaginal <1% 327 $11K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 264 $10K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 8,213 $10K
76801 <1% 191 $9K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 484 $9K
85027 <1% 1,879 $9K
87507 <1% 27 $9K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 155 $9K
80055 <1% 99 $8K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 1,399 $8K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 110 $8K
87070 <1% 402 $7K
97162 <1% 659 $7K
86803 <1% 548 $6K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 7,047 $6K
87088 <1% 1,023 $5K
84703 <1% 779 $5K
90686 <1% 563 $5K
86618 <1% 216 $5K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism <1% 75 $4K
86140 <1% 744 $4K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 259 $4K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 77 $4K
71275 Computed tomographic angiography, chest, with contrast material <1% 66 $4K
85379 <1% 598 $4K
86850 <1% 485 $4K
G0483 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed <1% 30 $4K
11721 <1% 479 $4K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 4,039 $4K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 273 $4K
91322 <1% 27 $4K
99239 Hospital discharge day management, more than 30 minutes <1% 168 $3K
81003 <1% 267 $3K
98926 <1% 198 $3K
82570 <1% 183 $3K
72125 Computed tomography, cervical spine; without contrast material <1% 178 $3K
86900 <1% 681 $3K
85007 <1% 861 $3K
36415 Collection of venous blood by venipuncture <1% 17,151 $3K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 45 $2K
73502 <1% 190 $2K
87040 <1% 303 $2K
99232 Hospital visit by a doctor, follow-up day <1% 199 $2K
92567 <1% 72 $2K
G0379 Direct admission of patient for hospital observation care <1% 209 $2K
77063 Screening digital breast tomosynthesis, bilateral <1% 143 $2K
96375 Therapeutic injection; each additional sequential IV push <1% 4,496 $2K
99308 Subsequent nursing facility care, per day, straightforward <1% 319 $2K
87150 <1% 30 $2K
82805 <1% 90 $2K
87081 <1% 87 $2K
97113 <1% 137 $2K
Q3014 Telehealth originating site facility fee <1% 110 $1K
97035 <1% 258 $1K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 126 $1K
87641 <1% 31 $1K
82607 <1% 111 $1K
20610 <1% 48 $1K
84145 <1% 46 $1K
86901 <1% 681 $1K
85652 <1% 549 $1K
A0426 Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) <1% 97 $1K
90715 <1% 134 $1K
73562 <1% 115 $1K
90670 <1% 329 $1K
G0383 Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) <1% 32 $1K
0011A <1% 40 $1K
72100 <1% 58 $995.18
88720 <1% 48 $993.34
G0463 Hospital outpatient clinic visit for assessment and management of a patient <1% 91 $912.35
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 14 $853.72
93976 <1% 26 $817.63
90698 <1% 258 $804.33
71045 Radiologic examination, chest; single view <1% 1,640 $741.04
92557 <1% 16 $733.88
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 3,792 $713.26
85018 <1% 184 $701.32
A0425 Ground mileage, per statute mile <1% 1,352 $668.38
12001 <1% 12 $631.08
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 14 $614.48
A0380 Bls mileage (per mile) <1% 46 $572.70
87210 <1% 122 $558.41
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 288 $513.86
82043 <1% 58 $510.45
93971 <1% 30 $508.21
85014 <1% 79 $495.34
82550 <1% 107 $446.85
99307 <1% 26 $436.64
82950 <1% 14 $396.04
80050 General health panel <1% 42 $388.44
73080 <1% 79 $373.72
85730 <1% 114 $354.86
73140 <1% 65 $353.80
82728 <1% 26 $325.84
97166 <1% 17 $316.43
99443 <1% 22 $310.30
11056 <1% 14 $291.48
74019 <1% 118 $288.04
86787 <1% 39 $245.92
74018 <1% 60 $242.55
83520 <1% 16 $198.87
90744 <1% 66 $191.98
A0428 Ambulance service, basic life support, non-emergency transport, (bls) <1% 17 $189.80
97163 <1% 43 $186.98
84100 <1% 52 $171.30
90681 <1% 55 $168.81
90658 <1% 13 $145.48
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg <1% 15 $140.46
83540 <1% 30 $134.90
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 37 $103.91
J2795 Injection, ropivacaine hydrochloride, 1 mg <1% 18 $73.50
82565 <1% 35 $70.82
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 139 $57.66
90710 <1% 17 $56.27
90723 <1% 15 $49.65
90648 <1% 14 $46.34
36000 <1% 802 $44.34
90633 <1% 13 $43.03
96376 <1% 468 $37.18
86592 <1% 15 $35.90
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 3,377 $20.87
J2704 Injection, propofol, 10 mg <1% 1,790 $19.74
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 1,534 $10.93
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 455 $6.77
J1170 Injection, hydromorphone, up to 4 mg <1% 217 $5.36
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 2,389 $5.32
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg <1% 115 $5.20
J3010 Injection, fentanyl citrate, 0.1 mg <1% 1,338 $5.15
J0690 Injection, cefazolin sodium, 500 mg <1% 331 $4.67
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 46 $3.00
J2060 Injection, lorazepam, 2 mg <1% 53 $1.42
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 893 $1.04
Q9963 High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml <1% 92 $0.18
91301 <1% 40 $0.07
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 0% 331 $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% 337 $0.00
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 0% 31 $0.00
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 0% 26 $0.00
94664 0% 17 $0.00
J2270 Injection, morphine sulfate, up to 10 mg 0% 17 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 0% 13 $0.00
A9270 Non-covered item or service 0% 1,445 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 0% 58 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 0% 140 $0.00
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 0% 14 $0.00
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals 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.

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