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

Prospect Rockville Hospital, INC.

Prospect Rockville Hospital, INC. was paid $30.06M by Medicaid between Jan 2018 and Dec 2024, across 228 billing codes. Its largest line is G0384, Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) — 21% of everything it billed.

33Billing provider infoPROSPECT ROCKVILLE HOSPITAL, INC.
VERNON, CT 06066
33aNPI1205283538assigned 05/17/2016
28Total paid$30.06M
24GClaims771,392
24DCodes billed228
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Emergency Care Clinic/Center providers in Connecticut

Rank by total paid#6 of 6
Median peer was paid$80.66M
This provider vs. median0.4×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$200K$400K$600K2018201920202021202220232024
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
2018119,694$4.28M
2019117,561$4.70M
202094,434$3.45M
2021115,256$4.31M
2022123,670$4.96M
2023104,229$4.26M
2024incomplete96,548$4.10M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
G0384 Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 21% 10,368 8,970 $6.35M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 11% 9,728 8,406 $3.34M
G0383 Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 6.9% 9,196 8,177 $2.07M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 6.4% 7,983 6,987 $1.94M
G0382 Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 6.3% 10,679 9,688 $1.88M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 6.0% 11,747 10,018 $1.81M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 5.5% 9,386 8,239 $1.65M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 3.9% 12,265 9,279 $1.17M
74177 Computed tomography, abdomen and pelvis; with contrast material 3.4% 4,325 3,992 $1.03M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 2.3% 23,236 7,055 $699K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1.9% 14,820 4,923 $570K
77067 Screening mammography, bilateral, including computer-aided detection 1.8% 4,707 4,623 $545K
216 more codes
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1.8% 873 $534K
96375 Therapeutic injection; each additional sequential IV push 1.6% 9,023 $486K
70450 Computed tomography, head or brain; without contrast material 1.6% 4,749 $476K
96361 Intravenous infusion, hydration; each additional hour 1.5% 7,906 $439K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1.4% 10,587 $414K
71046 Radiologic examination, chest; 2 views 1.4% 7,972 $412K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1.2% 2,608 $357K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 2,011 $272K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 1,785 $262K
71045 Radiologic examination, chest; single view <1% 5,121 $255K
97010 <1% 12,702 $189K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 4,052 $177K
G0381 Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) <1% 1,700 $170K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 1,518 $170K
77065 Tomosynthesis, mammo <1% 1,217 $122K
97161 <1% 1,983 $120K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 269 $117K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 1,140 $116K
76642 <1% 1,712 $95K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 985 $94K
99213 Doctor's office visit, returning patient (routine) <1% 1,474 $92K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 1,023 $88K
76641 <1% 1,464 $84K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 2,729 $81K
97162 <1% 1,327 $73K
93971 <1% 940 $63K
G0380 Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) <1% 932 $62K
97535 Self-care/home management training, each 15 minutes <1% 2,450 $62K
97014 <1% 4,011 $61K
97035 <1% 3,740 $61K
76830 Ultrasound, transvaginal <1% 680 $58K
82947 <1% 23,194 $57K
71275 Computed tomographic angiography, chest, with contrast material <1% 506 $55K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 68 $51K
90834 Psychotherapy session, about 45 minutes <1% 953 $47K
71250 <1% 878 $47K
73564 <1% 1,743 $44K
73610 <1% 1,939 $43K
72100 <1% 1,483 $41K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV <1% 457 $39K
73030 <1% 1,995 $35K
73630 <1% 2,012 $29K
97012 <1% 507 $28K
73130 <1% 1,632 $28K
77080 <1% 289 $27K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 114 $24K
73110 <1% 1,087 $23K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 7,472 $23K
72125 Computed tomography, cervical spine; without contrast material <1% 1,279 $23K
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% 322 $21K
97113 <1% 382 $19K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc <1% 448 $15K
G0378 Hospital observation service, per hour <1% 3,343 $15K
77066 Tomosynthesis, mammo <1% 137 $14K
73502 <1% 1,059 $14K
0012A <1% 362 $13K
0011A <1% 425 $13K
76536 <1% 150 $11K
73562 <1% 977 $10K
73140 <1% 389 $10K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 849 $9K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 849 $9K
70486 <1% 154 $7K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring <1% 25 $7K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 40 $6K
72110 <1% 97 $6K
36415 Collection of venous blood by venipuncture <1% 42,077 $6K
97165 <1% 85 $5K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 63 $5K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 11,825 $5K
76801 <1% 41 $4K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 23,893 $4K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 5,097 $4K
74018 <1% 157 $4K
80051 <1% 23,769 $4K
84443 Thyroid stimulating hormone (TSH) <1% 2,201 $3K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 55 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 3,464 $3K
97032 <1% 100 $2K
80053 Comprehensive metabolic panel <1% 737 $2K
J8499 Prescription drug, oral, non chemotherapeutic, nos <1% 1,146 $2K
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% 5,516 $2K
93970 <1% 12 $2K
82565 <1% 23,917 $2K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 13 $2K
72072 <1% 39 $2K
99215 Doctor's office visit, returning patient (complex) <1% 19 $2K
85610 <1% 3,780 $2K
J3490 Unclassified drugs <1% 35,612 $1K
80061 Lipid panel <1% 123 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 1,664 $1K
73080 <1% 57 $960.90
81025 <1% 8,821 $892.97
72040 <1% 40 $870.12
96367 <1% 14 $786.65
83735 <1% 6,735 $750.39
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 71 $706.05
99204 Doctor's office visit, new patient (more involved) <1% 164 $622.51
84520 <1% 23,812 $592.35
80048 Basic metabolic panel (calcium, ionized) <1% 462 $575.75
0002A <1% 54 $538.97
87086 Culture, bacterial; quantitative colony count, urine <1% 4,142 $538.57
85027 <1% 1,972 $524.16
83880 <1% 2,670 $513.56
84484 <1% 7,926 $494.77
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 2,325 $456.76
71101 <1% 24 $395.43
87070 <1% 2,388 $382.54
77061 <1% 133 $360.80
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 2,870 $336.84
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 15 $332.97
93017 <1% 12 $331.74
82553 <1% 544 $295.97
83690 <1% 9,525 $295.87
81001 <1% 7,847 $257.39
82247 <1% 17,951 $256.81
0001A <1% 45 $252.99
87186 <1% 1,573 $242.31
83036 Hemoglobin; glycosylated (A1C) <1% 97 $240.11
85007 <1% 1,489 $221.82
82040 <1% 17,980 $214.23
84450 <1% 18,075 $212.28
81002 <1% 12,273 $212.08
84075 <1% 17,948 $204.02
99203 Doctor's office visit, new patient (routine) <1% 198 $198.50
85379 <1% 2,341 $190.68
73090 <1% 12 $182.18
84460 <1% 18,083 $182.10
73590 <1% 14 $181.06
84155 <1% 17,961 $152.87
86900 <1% 936 $146.65
94761 <1% 2,451 $144.05
86885 <1% 61 $137.31
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 7,002 $133.42
83605 <1% 2,764 $111.37
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose <1% 26 $110.00
84702 <1% 561 $106.65
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 6,565 $105.17
85730 <1% 573 $105.03
90714 <1% 594 $101.99
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care <1% 65 $101.12
82728 <1% 158 $94.34
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 7,458 $90.09
86140 <1% 397 $87.64
96376 <1% 2,769 $84.59
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 203 $83.23
82310 <1% 3,091 $79.03
82948 <1% 2,873 $75.03
87040 <1% 1,634 $74.35
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 882 $71.30
87077 <1% 393 $66.22
84145 <1% 507 $61.82
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 733 $55.57
87205 <1% 367 $52.91
84100 <1% 793 $50.60
85652 <1% 141 $49.79
86901 <1% 936 $47.49
82550 <1% 261 $37.56
91300 <1% 82 $33.33
J7030 Infusion, normal saline solution , 1000 cc <1% 9,567 $31.58
J1170 Injection, hydromorphone, up to 4 mg <1% 4,447 $28.18
87420 <1% 525 $24.54
36416 <1% 2,878 $20.11
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 908 $19.69
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% 1,421 $18.72
86618 <1% 82 $16.27
82140 <1% 28 $13.92
80164 <1% 13 $12.94
80076 <1% 25 $12.91
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 273 $10.54
J2270 Injection, morphine sulfate, up to 10 mg <1% 3,168 $9.74
86403 <1% 116 $9.73
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 1,233 $9.32
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 2,318 $5.12
J2550 Injection, promethazine hcl, up to 50 mg <1% 618 $4.05
94760 <1% 914 $3.51
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg <1% 346 $3.22
J2060 Injection, lorazepam, 2 mg <1% 2,535 $3.19
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 1,477 $3.13
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 993 $3.08
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 1,100 $1.84
A9150 Non-prescription drugs <1% 1,232 $1.66
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting <1% 285 $1.31
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals <1% 210 $1.10
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting <1% 30 $0.11
A9575 Injection, gadoterate meglumine, 0.1 ml 0% 189 $0.00
88313 0% 284 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 0% 543 $0.00
82075 0% 274 $0.00
82800 0% 14 $0.00
C9113 Injection, pantoprazole sodium, per vial 0% 85 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 0% 143 $0.00
J1644 Injection, heparin sodium, per 1000 units 0% 117 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 0% 42 $0.00
J1171 Injection, hydromorphone, 0.1 mg 0% 123 $0.00
77062 0% 26 $0.00
Q0243 Injection, casirivimab and imdevimab, 2400 mg 0% 36 $0.00
93041 0% 134 $0.00
88342 0% 327 $0.00
J1630 Injection, haloperidol, up to 5 mg 0% 341 $0.00
J1790 Injection, droperidol, up to 5 mg 0% 123 $0.00
77063 Screening digital breast tomosynthesis, bilateral 0% 2,466 $0.00
J7050 Infusion, normal saline solution, 250 cc 0% 1,545 $0.00
A9270 Non-covered item or service 0% 178 $0.00
83615 0% 95 $0.00
84703 0% 100 $0.00
12001 0% 66 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 0% 38 $0.00
J1815 Injection, insulin, per 5 units 0% 48 $0.00
J2704 Injection, propofol, 10 mg 0% 252 $0.00
J8540 Dexamethasone, oral, 0.25 mg 0% 97 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 0% 57 $0.00
91301 0% 782 $0.00
A9585 Injection, gadobutrol, 0.1 ml 0% 13 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 0% 13 $0.00
99214 Doctor's office visit, returning patient (more involved) 0% 16 $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 officialELDERS, ROBERT (SECRETARY)
Same official

Other billing entities under ELDERS, ROBERT

Full network →
ProviderLocationPaid
Prospect Waterbury, INC.Waterbury, CT$84.62M
Prospect Manchester Hospital, INC.Manchester, CT$69.20M
Prospect Chartercare RWMC, LLCProvidence, RI$57.10M
Prospect CCMC, LLCChester, PA$40.89M
Prospect CT Medical Foundation, INC.Manchester, CT$34.07M
Prospect Chartercare Sjhsri, LLCNorth Providence, RI$10.94M
Prospect DCMH, LLCDrexel Hill, PA$10.37M
Prospect CCMC, LLCChester, PA$5.46M
Alta Los Angeles Hospitals, INC.Los Angeles, CA$5.42M
Prospect CCMC, LLCChester, PA$5.03M
Prospect CCMC, LLCChester, PA$3.71M
Prospect Chartercare Physicians, LLCCranston, RI$2.31M
Prospect Echn Home Health, INC.Vernon, CT$1.75M
Prospect Waterbury Home Health, INC.Watertown, CT$1.30M
Prospect Health Access Network, INC.Chester, PA$1.22M
Alta Newport Hospital, LLCTustin, CA$1.16M
Prospect Health Access Network, INC.Crum Lynne, PA$924K
Prospect Health Access Network, INC.Chester, PA$872K
Prospect Chartercare Sjhsri, LLCNorth Providence, RI$858K
Prospect Health Access Network, INC.Drexel Hill, PA$815K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.