ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER

NPI: 1144729716 · BELLEVILLE, IL 62220 · Mammography Clinic/Center · NPI assigned 02/08/2018

$38K

Total Medicaid Paid

424

Total Claims

151

Beneficiaries

Codes Billed

2019-04

First Month

2019-08

Last Month

Provider Details

Authorized Official	EVARD, MARK (VP OF REVENUE CYCLE)
Parent Organization	ST. ELIZABETH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER
NPI Enumeration Date	02/08/2018

Other providers sharing the same authorized official: EVARD, MARK

Provider	City	State	Total Paid
ST MARYS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS	DECATUR	IL	$7.04M
ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F	SPRINGFIELD	IL	$1.70M
ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F	SPRINGFIELD	IL	$1.33M
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER	O FALLON	IL	$637K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	GERMANTOWN	IL	$135K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	NEW BADEN	IL	$133K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	CARLYLE	IL	$39K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	TRENTON	IL	$15K

Year	Claims	Total Paid
2019	424	$38K

Code	Description	Claims	Beneficiaries	Total Paid
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	284	63	$33K
77067	Screening mammography, bilateral, including computer-aided detection	92	44	$5K
77063	Screening digital breast tomosynthesis, bilateral	48	44	$659.04