Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Hospital

Tomah Memorial Hospital INC

Tomah Memorial Hospital INC was paid $16.05M by Medicaid between Jan 2018 and Dec 2024, across 159 billing codes. Its largest line is 99283, emergency room visit (moderate) — 16% of everything it billed.

33Billing provider infoTOMAH MEMORIAL HOSPITAL INC
TOMAH, WI 54660
33aNPI1184765240assigned 02/10/2007
33bProvider typeGeneral Acute Care Hospital
28Total paid$16.05M
24GClaims266,165
24DCodes billed159
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other General Acute Care Hospital providers in Wisconsin

Rank by total paid#12 of 60
Median peer was paid$2.90M
This provider vs. median5.5×

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

$0$200K$400K2018201920202021202220232024
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
201829,652$1.75M
201931,424$1.55M
202027,313$1.63M
202135,993$2.02M
202246,126$2.85M
202353,842$3.30M
2024incomplete41,815$2.96M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 16% 14,165 11,601 $2.62M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 15% 16,973 14,252 $2.36M
96361 Intravenous infusion, hydration; each additional hour 11% 4,196 3,209 $1.76M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 9.3% 9,795 7,677 $1.49M
99282 Emergency department visit for the evaluation and management, low to moderate severity 8.9% 7,971 6,743 $1.42M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 5.8% 4,129 2,304 $930K
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 4.0% 4,238 3,389 $644K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3.7% 4,916 3,861 $588K
74177 Computed tomography, abdomen and pelvis; with contrast material 2.8% 2,085 1,527 $449K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 2.8% 1,280 725 $444K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 2.3% 2,909 2,554 $367K
70450 Computed tomography, head or brain; without contrast material 2.3% 2,152 1,447 $363K
147 more codes
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 2.2% 10,219 $349K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 2.1% 1,414 $334K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 1.3% 1,841 $206K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1.0% 5,468 $168K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 835 $131K
87631 <1% 991 $98K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 953 $93K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 2,864 $85K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,773 $74K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 3,602 $72K
99214 Doctor's office visit, returning patient (more involved) <1% 607 $67K
80053 Comprehensive metabolic panel <1% 7,780 $63K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 12,491 $62K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder <1% 1,282 $48K
G0463 Hospital outpatient clinic visit for assessment and management of a patient <1% 2,243 $43K
G0378 Hospital observation service, per hour <1% 874 $42K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 210 $42K
97162 <1% 1,010 $39K
87430 <1% 1,913 $35K
80048 Basic metabolic panel (calcium, ionized) <1% 5,681 $35K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 183 $34K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 809 $30K
96367 <1% 160 $29K
85027 <1% 2,541 $27K
81025 <1% 3,169 $26K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 1,054 $21K
81001 <1% 4,852 $19K
71046 Radiologic examination, chest; 2 views <1% 5,616 $19K
99203 Doctor's office visit, new patient (routine) <1% 182 $17K
84484 <1% 2,631 $17K
83690 <1% 3,426 $16K
87081 <1% 1,678 $14K
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% 189 $14K
87086 Culture, bacterial; quantitative colony count, urine <1% 2,310 $13K
97535 Self-care/home management training, each 15 minutes <1% 754 $12K
83605 <1% 2,097 $11K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 4,301 $11K
81003 <1% 4,286 $10K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 5,214 $9K
84443 Thyroid stimulating hormone (TSH) <1% 875 $9K
76830 Ultrasound, transvaginal <1% 48 $9K
83735 <1% 2,813 $9K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 5,475 $9K
87186 <1% 1,379 $8K
84145 <1% 702 $7K
87077 <1% 1,426 $7K
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% 204 $7K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 172 $7K
82077 <1% 680 $6K
87040 <1% 1,314 $6K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 31 $5K
85379 <1% 782 $5K
80305 <1% 583 $5K
71045 Radiologic examination, chest; single view <1% 2,094 $5K
82962 <1% 2,339 $4K
85610 <1% 1,633 $4K
80306 <1% 332 $4K
12001 <1% 16 $4K
85007 <1% 1,396 $3K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 43 $3K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 87 $3K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 87 $3K
80143 <1% 236 $2K
80179 <1% 243 $2K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 19 $2K
93971 <1% 17 $2K
73610 <1% 683 $2K
82803 <1% 177 $2K
83880 <1% 142 $2K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 21 $2K
86140 <1% 569 $2K
99215 Doctor's office visit, returning patient (complex) <1% 12 $1K
87070 <1% 184 $1K
82565 <1% 500 $1K
73630 <1% 426 $1K
J0561 Injection, penicillin g benzathine, 100,000 units <1% 21 $1K
82948 <1% 252 $1K
96375 Therapeutic injection; each additional sequential IV push <1% 4,050 $1K
82247 <1% 647 $1K
84460 <1% 540 $1K
85730 <1% 305 $1K
87147 <1% 170 $1K
86617 <1% 49 $1K
36415 Collection of venous blood by venipuncture <1% 3,643 $914.73
87905 <1% 95 $867.08
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism <1% 30 $833.98
84450 <1% 373 $669.89
97163 <1% 17 $623.60
87220 <1% 155 $598.85
97166 <1% 15 $542.17
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 32 $505.61
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 3,110 $454.59
73110 <1% 68 $409.38
73030 <1% 104 $391.88
J7030 Infusion, normal saline solution , 1000 cc <1% 5,259 $376.18
94762 <1% 146 $321.03
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 5,288 $299.04
73130 <1% 47 $294.41
84075 <1% 143 $294.25
80050 General health panel <1% 176 $231.54
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen <1% 1,343 $185.56
87808 <1% 16 $173.80
84703 <1% 28 $173.55
90715 <1% 13 $169.37
J7120 Ringers lactate infusion, up to 1000 cc <1% 3,518 $165.83
96376 <1% 716 $153.22
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units <1% 1,545 $146.27
87205 <1% 66 $127.75
86900 <1% 43 $125.25
86901 <1% 60 $113.49
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 3,728 $113.33
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 769 $110.65
J2704 Injection, propofol, 10 mg <1% 1,536 $101.24
A9270 Non-covered item or service <1% 2,875 $87.88
87088 <1% 16 $77.59
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 1,799 $69.66
86850 <1% 29 $64.56
82040 <1% 16 $61.99
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 85 $52.85
J7050 Infusion, normal saline solution, 250 cc <1% 3,736 $52.13
73562 <1% 13 $40.92
80320 <1% 99 $37.64
80051 <1% 18 $36.20
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 1,259 $35.07
85652 <1% 13 $27.90
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 551 $25.59
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg <1% 260 $19.51
J3010 Injection, fentanyl citrate, 0.1 mg <1% 2,222 $18.94
82272 <1% 14 $17.04
J1170 Injection, hydromorphone, up to 4 mg <1% 643 $15.38
J7060 5% dextrose/water (500 ml = 1 unit) <1% 675 $14.79
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 614 $13.99
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 13 $5.22
J0690 Injection, cefazolin sodium, 500 mg <1% 240 $2.71
73564 <1% 54 $2.13
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) <1% 101 $0.60
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) 0% 107 $0.00
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf 0% 15 $0.00
J1650 Injection, enoxaparin sodium, 10 mg 0% 29 $0.00
74018 0% 15 $0.00
J1756 Injection, iron sucrose, 1 mg 0% 21 $0.00
J3490 Unclassified drugs 0% 187 $0.00
J2765 Injection, metoclopramide hcl, up to 10 mg 0% 88 $0.00
36000 0% 21 $0.00
J8540 Dexamethasone, oral, 0.25 mg 0% 14 $0.00
J1790 Injection, droperidol, up to 5 mg 0% 84 $0.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 0% 71 $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 officialZEPS, JOSEPH (CFO)