NP / PA
Mount ST. Mary's Hospital of Niagara Falls
Mount ST. Mary's Hospital of Niagara Falls was paid $2.87M by Medicaid between Oct 2020 and Dec 2024, across 46 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 38% of everything it billed.
33Billing provider infoMOUNT ST. MARY'S HOSPITAL OF NIAGARA FALLS
LEWISTON, NY 14092
LEWISTON, NY 14092
33aNPI1184252751assigned 03/30/2020
33bProvider typeNurse Practitioner
28Total paid$2.87M
24GClaims56,827
24DCodes billed46
24AFirst – last monthOct 2020 – Dec 2024
Compared with peers
Next to other Nurse Practitioner providers in New York
Rank by total paid#5 of 346
Median peer was paid$1K
This provider vs. median2,003×
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 | |
|---|---|---|---|
| 2020 | 1,406 | $66K | |
| 2021 | 14,046 | $764K | |
| 2022 | 16,776 | $893K | |
| 2023 | 17,807 | $885K | |
| 2024incomplete | 6,792 | $264K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 38% | 15,445 | 14,948 | $1.10M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 30% | 17,706 | 16,555 | $851K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 5.0% | 1,284 | 1,283 | $145K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.1% | 1,724 | 1,722 | $119K |
| 59425 | 3.4% | 885 | 714 | $97K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 3.0% | 1,749 | 1,746 | $86K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.8% | 1,548 | 1,548 | $81K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.4% | 10,225 | 9,541 | $70K |
| 59426 | 2.2% | 571 | 329 | $64K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.9% | 749 | 749 | $53K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 433 | 431 | $25K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 239 | 239 | $23K |
34 more codes
| 69210 | <1% | 714 | $19K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 530 | $19K |
| 99221 | <1% | 235 | $15K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 280 | $15K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 242 | $15K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 103 | $12K |
| 93018 | <1% | 561 | $7K | |
| 99223 | Prolong inpt eval add15 m | <1% | 55 | $7K |
| 93016 | <1% | 361 | $6K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 167 | $5K |
| 99442 | <1% | 107 | $5K | |
| 59514 | <1% | 12 | $4K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 80 | $4K |
| 97597 | <1% | 107 | $3K | |
| 99441 | <1% | 90 | $2K | |
| 59430 | <1% | 12 | $2K | |
| 99443 | <1% | 21 | $1K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 24 | $1K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 41 | $1K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 27 | $1K |
| 76801 | <1% | 26 | $1K | |
| 90785 | <1% | 90 | $977.19 | |
| 88307 | <1% | 52 | $973.44 | |
| 93227 | <1% | 26 | $931.56 | |
| 31231 | <1% | 13 | $885.09 | |
| 20610 | <1% | 25 | $783.75 | |
| 31575 | <1% | 12 | $748.48 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 88 | $671.10 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 12 | $626.72 |
| 88304 | <1% | 27 | $588.65 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 14 | $446.04 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 49 | $244.20 |
| 93356 | <1% | 42 | $39.80 | |
| 81025 | <1% | 24 | $10.15 |
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 officialMACHOLZ, DAVID (ATHORIZED OFFICIAL)
Parent organizationMOUNT ST. MARY'S HOSPITAL OF NIAGARA FALLS
| Provider | Location | Paid |
|---|---|---|
| Mercy Hospital of Buffalo | Buffalo, NY | $29.86M |
| Mount ST. Mary's Hospital of Niagara Falls | Lewiston, NY | $22.19M |
| Sisters of Charity Hospital of Buffalo New York | Cheektowaga, NY | $13.42M |
| Sisters of Charity Hospital of Buffalo New York | Buffalo, NY | $3.93M |
| Mercy Hospital of Buffalo | Buffalo, NY | $449K |
| Kenmore Mercy Hospital | Kenmore, NY | $70K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.