Edgerton Hospital and Health Services INC.

Edgerton Hospital and Health Services INC. was paid $3.86M by Medicaid between Jan 2018 and Dec 2024, across 61 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 29% of everything it billed.

33Billing provider infoEDGERTON HOSPITAL AND HEALTH SERVICES INC.
EDGERTON, WI 53534

33aNPI1154350049assigned 07/02/2006

33bProvider typeMulti-Specialty Clinic/Center

28Total paid$3.86M

24GClaims30,976

24DCodes billed61

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Multi-Specialty Clinic/Center providers in Wisconsin

Rank by total paid#9 of 40

Median peer was paid$333K

This provider vs. median12×

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	2,780	$293K
2019	4,049	$462K
2020	3,685	$500K
2021	5,655	$533K
2022	4,989	$515K
2023	5,544	$740K
2024incomplete	4,274	$816K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	29%	3,987	3,385	$1.12M
99282	Emergency department visit for the evaluation and management, low to moderate severity	15%	1,352	1,163	$580K
41899	Unlisted procedure, dentoalveolar structures	14%	207	162	$527K
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	11%	1,353	1,014	$425K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	8.4%	1,329	1,043	$323K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	5.0%	619	503	$195K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	4.7%	602	530	$181K
96361	Intravenous infusion, hydration; each additional hour	3.9%	185	145	$150K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	3.1%	429	343	$118K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	1.4%	299	145	$56K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	1,062	936	$38K
80053	Comprehensive metabolic panel	<1%	2,612	2,134	$30K

49 more codes

87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	<1%	316	$24K
99214	Doctor's office visit, returning patient (more involved)	<1%	90	$14K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	2,476	$12K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	<1%	299	$11K
71046	Radiologic examination, chest; 2 views	<1%	204	$10K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	688	$10K
87081		<1%	666	$5K
81001		<1%	1,193	$4K
00170	Anesthesia for intraoral procedures, including biopsy	<1%	41	$3K
93005	Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	<1%	920	$3K
36415	Collection of venous blood by venipuncture	<1%	3,189	$3K
80048	Basic metabolic panel (calcium, ionized)	<1%	411	$2K
96374	Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance	<1%	359	$2K
84484		<1%	230	$1K
81025		<1%	216	$1K
80061	Lipid panel	<1%	103	$1K
83605		<1%	102	$848.49
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	42	$764.75
71045	Radiologic examination, chest; single view	<1%	121	$763.88
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	311	$678.63
87801	Infectious agent detection by nucleic acid; amplified probe, multiple organisms	<1%	14	$624.44
83690		<1%	117	$601.88
0012A		<1%	14	$581.11
83036	Hemoglobin; glycosylated (A1C)	<1%	77	$576.58
82607		<1%	58	$560.88
0011A		<1%	16	$528.88
85027		<1%	124	$510.56
84443	Thyroid stimulating hormone (TSH)	<1%	39	$468.72
85610		<1%	113	$374.55
82746		<1%	36	$364.56
96375	Therapeutic injection; each additional sequential IV push	<1%	80	$354.04
0031A		<1%	20	$339.48
80050	General health panel	<1%	15	$267.79
84439		<1%	35	$223.68
83735		<1%	33	$131.48
J7030	Infusion, normal saline solution , 1000 cc	<1%	435	$91.67
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	<1%	429	$80.24
87086	Culture, bacterial; quantitative colony count, urine	<1%	16	$66.72
91301		<1%	16	$35.50
85007		<1%	13	$28.08
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	1,015	$17.12
J7120	Ringers lactate infusion, up to 1000 cc	<1%	434	$12.07
J7050	Infusion, normal saline solution, 250 cc	<1%	235	$8.92
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	752	$6.72
J2405	Injection, ondansetron hydrochloride, per 1 mg	<1%	188	$2.18
J3010	Injection, fentanyl citrate, 0.1 mg	<1%	141	$1.45
J7040	Infusion, normal saline solution, sterile (500 ml = 1 unit)	<1%	32	$0.10
J2704	Injection, propofol, 10 mg	0%	400	$0.00
J0665	Injection, bupivicaine, not otherwise specified, 0.5 mg	0%	66	$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 officialAUGSBURGER, MARC (PRESIDENT AND CEO)