Hospital
SJ Medical Center, LLC
SJ Medical Center, LLC was paid $5.39M by Medicaid between Oct 2019 and Oct 2024, across 95 billing codes. Its largest line is 99285, emergency room visit (most serious) — 28% of everything it billed.
33Billing provider infoSJ MEDICAL CENTER, LLC
HOUSTON, TX 77002
HOUSTON, TX 77002
33aNPI1154361475assigned 06/07/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$5.39M
24GClaims108,342
24DCodes billed95
24AFirst – last monthOct 2019 – Oct 2024
Compared with peers
Next to other General Acute Care Hospital providers in Texas
Rank by total paid#34 of 109
Median peer was paid$1.15M
This provider vs. median4.7×
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 | |
|---|---|---|---|
| 2019 | 134 | $4K | |
| 2020 | 6,909 | $502K | |
| 2021 | 31,756 | $1.62M | |
| 2022 | 30,460 | $1.25M | |
| 2023 | 27,249 | $1.44M | |
| 2024incomplete | 11,834 | $572K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 28% | 4,629 | 4,224 | $1.52M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 19% | 4,223 | 3,933 | $1.03M |
| 59025 | Fetal non-stress test | 8.9% | 3,934 | 3,181 | $478K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 8.2% | 3,936 | 3,350 | $444K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.4% | 4,335 | 3,317 | $292K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 3.0% | 3,153 | 2,973 | $160K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.0% | 2,653 | 2,559 | $160K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.4% | 2,249 | 2,133 | $130K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 2.1% | 1,937 | 1,757 | $113K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 2.0% | 1,905 | 1,671 | $106K |
| 80053 | Comprehensive metabolic panel | 1.9% | 9,337 | 8,309 | $105K |
| 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 | 1.9% | 1,129 | 939 | $104K |
83 more codes
| 99204 | Doctor's office visit, new patient (more involved) | 1.7% | 1,049 | $94K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.6% | 10,988 | $88K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 1,581 | $79K |
| 87653 | 1.0% | 1,376 | $56K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 329 | $46K |
| 81002 | <1% | 8,867 | $37K | |
| 71045 | Radiologic examination, chest; single view | <1% | 1,411 | $36K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 656 | $28K |
| 86850 | <1% | 1,261 | $23K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 253 | $18K |
| 87486 | <1% | 418 | $18K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 421 | $17K |
| 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% | 142 | $15K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 101 | $14K |
| 81001 | <1% | 4,177 | $13K | |
| 84484 | <1% | 1,287 | $11K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 153 | $9K |
| 86780 | <1% | 615 | $9K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,132 | $9K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 429 | $8K |
| 82077 | <1% | 476 | $8K | |
| 86701 | <1% | 722 | $7K | |
| 56820 | <1% | 82 | $6K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 364 | $6K |
| 83615 | <1% | 723 | $5K | |
| 82570 | <1% | 731 | $5K | |
| 80320 | <1% | 351 | $5K | |
| 86703 | <1% | 226 | $4K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 12 | $4K |
| 83880 | <1% | 147 | $4K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 1,318 | $4K |
| 86901 | <1% | 1,296 | $4K | |
| 86900 | <1% | 1,296 | $4K | |
| 86803 | <1% | 221 | $4K | |
| 84156 | <1% | 734 | $3K | |
| 87899 | <1% | 164 | $3K | |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | <1% | 31 | $3K |
| 76818 | <1% | 19 | $3K | |
| 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% | 95 | $2K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 79 | $2K |
| 84112 | <1% | 26 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 78 | $2K |
| 86762 | <1% | 143 | $2K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 13 | $2K |
| 86592 | <1% | 344 | $2K | |
| 83690 | <1% | 267 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 116 | $2K |
| 85027 | <1% | 253 | $2K | |
| 81003 | <1% | 678 | $2K | |
| 85610 | <1% | 534 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 43 | $1K |
| 84702 | <1% | 114 | $1K | |
| 59430 | <1% | 44 | $1K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 83 | $1K |
| 87340 | <1% | 104 | $1K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 33 | $1K |
| 82550 | <1% | 120 | $938.94 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 13,245 | $874.01 |
| 81025 | <1% | 85 | $725.05 | |
| G0378 | Hospital observation service, per hour | <1% | 29 | $640.33 |
| 90674 | <1% | 44 | $635.42 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 29 | $586.04 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 448 | $537.10 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 104 | $508.52 |
| 87088 | <1% | 26 | $463.82 | |
| 85730 | <1% | 116 | $405.92 | |
| 87210 | <1% | 67 | $392.67 | |
| 90661 | <1% | 27 | $341.54 | |
| 84703 | <1% | 16 | $256.47 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 15 | $242.12 |
| 83020 | <1% | 13 | $185.74 | |
| 90656 | <1% | 13 | $94.15 | |
| 87147 | <1% | 18 | $89.56 | |
| 83605 | <1% | 12 | $82.57 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 338 | $82.24 |
| 87081 | <1% | 13 | $81.49 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 77 | $41.75 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 52 | $24.42 |
| 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% | 56 | $20.70 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 62 | $6.41 |
| J2704 | Injection, propofol, 10 mg | 0% | 381 | $0.00 |
| A9270 | Non-covered item or service | 0% | 695 | $0.00 |
| 82962 | 0% | 215 | $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 officialBASSETT, KIMBERLY (HOSPITAL PRESIDENT)