Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PROSPECT ROCKVILLE HOSPITAL, INC.

NPI: 1205283538 · VERNON, CT 06066 · Emergency Care Clinic/Center · NPI assigned 05/17/2016

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more

$30.06M
Total Medicaid Paid
771,392
Total Claims
596,572
Beneficiaries
228
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date05/17/2016

Related Entities

Other providers sharing the same authorized official: ELDERS, ROBERT

ProviderCityStateTotal Paid
PROSPECT WATERBURY, INC. WATERBURY CT $84.62M
PROSPECT MANCHESTER HOSPITAL, INC. MANCHESTER CT $69.20M
PROSPECT CHARTERCARE RWMC, LLC PROVIDENCE RI $57.10M
PROSPECT CCMC, LLC CHESTER PA $40.89M
PROSPECT CT MEDICAL FOUNDATION, INC. MANCHESTER CT $34.07M
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $10.94M
PROSPECT DCMH, LLC DREXEL HILL PA $10.37M
PROSPECT CCMC, LLC CHESTER PA $5.46M
ALTA LOS ANGELES HOSPITALS, INC. LOS ANGELES CA $5.42M
PROSPECT CCMC, LLC CHESTER PA $5.03M
PROSPECT CCMC, LLC CHESTER PA $3.71M
PROSPECT CHARTERCARE PHYSICIANS, LLC CRANSTON 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, LLC TUSTIN CA $1.16M
PROSPECT HEALTH ACCESS NETWORK, INC. CRUM LYNNE PA $924K
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $872K
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $858K
PROSPECT HEALTH ACCESS NETWORK, INC. DREXEL HILL PA $815K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 119,694 $4.28M
2019 117,561 $4.70M
2020 94,434 $3.45M
2021 115,256 $4.31M
2022 123,670 $4.96M
2023 104,229 $4.26M
2024 96,548 $4.10M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
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) 10,368 8,970 $6.35M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 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) 9,196 8,177 $2.07M
99284 Emergency department visit for the evaluation and management, high severity 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) 10,679 9,688 $1.88M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 11,747 10,018 $1.81M
99283 Emergency department visit for the evaluation and management, moderate severity 9,386 8,239 $1.65M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 12,265 9,279 $1.17M
74177 Computed tomography, abdomen and pelvis; with contrast material 4,325 3,992 $1.03M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 23,236 7,055 $699K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 14,820 4,923 $570K
77067 Screening mammography, bilateral, including computer-aided detection 4,707 4,623 $545K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 873 807 $534K
96375 Therapeutic injection; each additional sequential IV push 9,023 7,399 $486K
70450 Computed tomography, head or brain; without contrast material 4,749 4,318 $476K
96361 Intravenous infusion, hydration; each additional hour 7,906 6,574 $439K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 10,587 9,633 $414K
71046 Radiologic examination, chest; 2 views 7,972 7,181 $412K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 2,608 2,349 $357K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 2,011 1,824 $272K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,785 1,666 $262K
71045 Radiologic examination, chest; single view 5,121 4,563 $255K
97010 12,702 4,370 $189K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 4,052 1,782 $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) 1,700 1,621 $170K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1,518 1,403 $170K
77065 Tomosynthesis, mammo 1,217 1,136 $122K
97161 1,983 1,890 $120K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 269 249 $117K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,140 1,100 $116K
76642 1,712 1,503 $95K
76705 Ultrasound, abdominal, real time with image documentation; limited 985 923 $94K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,474 1,332 $92K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 1,023 957 $88K
76641 1,464 891 $84K
97530 Therapeutic activities, direct patient contact, each 15 minutes 2,729 1,261 $81K
97162 1,327 1,259 $73K
93971 940 874 $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) 932 869 $62K
97535 Self-care/home management training, each 15 minutes 2,450 1,735 $62K
97014 4,011 1,822 $61K
97035 3,740 1,568 $61K
76830 Ultrasound, transvaginal 680 624 $58K
82947 23,194 19,666 $57K
71275 Computed tomographic angiography, chest, with contrast material 506 463 $55K
45380 Colonoscopy, flexible; with biopsy, single or multiple 68 65 $51K
90834 Psychotherapy, 45 minutes with patient 953 567 $47K
71250 878 845 $47K
73564 1,743 1,462 $44K
73610 1,939 1,711 $43K
72100 1,483 1,427 $41K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 457 444 $39K
73030 1,995 1,762 $35K
73630 2,012 1,783 $29K
97012 507 209 $28K
73130 1,632 1,372 $28K
77080 289 281 $27K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 114 106 $24K
73110 1,087 918 $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 7,472 6,738 $23K
72125 Computed tomography, cervical spine; without contrast material 1,279 1,173 $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 322 309 $21K
97113 382 162 $19K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 448 392 $15K
G0378 Hospital observation service, per hour 3,343 2,749 $15K
77066 Tomosynthesis, mammo 137 134 $14K
73502 1,059 997 $14K
0012A 362 354 $13K
0011A 425 366 $13K
76536 150 146 $11K
73562 977 798 $10K
73140 389 338 $10K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 849 779 $9K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 849 779 $9K
70486 154 147 $7K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 25 21 $7K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 40 39 $6K
72110 97 96 $6K
36415 Collection of venous blood by venipuncture 42,077 22,174 $6K
97165 85 76 $5K
71260 Computed tomography, thorax, diagnostic; with contrast material 63 57 $5K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 11,825 10,290 $5K
76801 41 38 $4K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 23,893 19,939 $4K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 5,097 4,392 $4K
74018 157 143 $4K
80051 23,769 19,901 $4K
84443 Thyroid stimulating hormone (TSH) 2,201 2,017 $3K
99281 Emergency department visit for the evaluation and management, self-limited or minor 55 46 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 3,464 2,577 $3K
97032 100 55 $2K
80053 Comprehensive metabolic panel 737 633 $2K
J8499 Prescription drug, oral, non chemotherapeutic, nos 1,146 901 $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 5,516 4,370 $2K
93970 12 12 $2K
82565 23,917 20,018 $2K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 13 12 $2K
72072 39 39 $2K
99215 Prolong outpt/office vis 19 12 $2K
85610 3,780 3,059 $2K
J3490 Unclassified drugs 35,612 15,989 $1K
80061 Lipid panel 123 117 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,664 1,160 $1K
73080 57 51 $960.90
81025 8,821 7,823 $892.97
72040 40 39 $870.12
96367 14 13 $786.65
83735 6,735 5,857 $750.39
99231 Subsequent hospital care, per day, straightforward or low complexity 71 15 $706.05
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 164 158 $622.51
84520 23,812 19,936 $592.35
80048 Basic metabolic panel (calcium, ionized) 462 332 $575.75
0002A 54 30 $538.97
87086 Culture, bacterial; quantitative colony count, urine 4,142 3,727 $538.57
85027 1,972 1,696 $524.16
83880 2,670 2,400 $513.56
84484 7,926 6,723 $494.77
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,325 2,181 $456.76
71101 24 24 $395.43
87070 2,388 2,200 $382.54
77061 133 127 $360.80
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,870 2,658 $336.84
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 15 12 $332.97
93017 12 12 $331.74
82553 544 421 $295.97
83690 9,525 8,250 $295.87
81001 7,847 6,976 $257.39
82247 17,951 15,399 $256.81
0001A 45 30 $252.99
87186 1,573 1,430 $242.31
83036 Hemoglobin; glycosylated (A1C) 97 89 $240.11
85007 1,489 1,258 $221.82
82040 17,980 15,395 $214.23
84450 18,075 15,466 $212.28
81002 12,273 10,494 $212.08
84075 17,948 15,397 $204.02
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 198 195 $198.50
85379 2,341 2,146 $190.68
73090 12 12 $182.18
84460 18,083 15,475 $182.10
73590 14 14 $181.06
84155 17,961 15,387 $152.87
86900 936 826 $146.65
94761 2,451 2,179 $144.05
86885 61 52 $137.31
J2405 Injection, ondansetron hydrochloride, per 1 mg 7,002 5,366 $133.42
83605 2,764 2,419 $111.37
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 26 25 $110.00
84702 561 498 $106.65
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 6,565 6,025 $105.17
85730 573 505 $105.03
90714 594 555 $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 65 29 $101.12
82728 158 141 $94.34
J1885 Injection, ketorolac tromethamine, per 15 mg 7,458 6,371 $90.09
86140 397 333 $87.64
96376 2,769 2,104 $84.59
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 203 184 $83.23
82310 3,091 2,802 $79.03
82948 2,873 2,172 $75.03
87040 1,634 1,467 $74.35
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 882 801 $71.30
87077 393 351 $66.22
84145 507 457 $61.82
88305 Level IV - Surgical pathology, gross and microscopic examination 733 600 $55.57
87205 367 318 $52.91
84100 793 692 $50.60
85652 141 123 $49.79
86901 936 826 $47.49
82550 261 227 $37.56
91300 82 42 $33.33
J7030 Infusion, normal saline solution , 1000 cc 9,567 7,627 $31.58
J1170 Injection, hydromorphone, up to 4 mg 4,447 2,046 $28.18
87420 525 481 $24.54
36416 2,878 2,162 $20.11
J1100 Injection, dexamethasone sodium phosphate, 1 mg 908 826 $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 1,421 1,232 $18.72
86618 82 80 $16.27
82140 28 24 $13.92
80164 13 12 $12.94
80076 25 24 $12.91
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 273 219 $10.54
J2270 Injection, morphine sulfate, up to 10 mg 3,168 2,195 $9.74
86403 116 106 $9.73
J0696 Injection, ceftriaxone sodium, per 250 mg 1,233 1,067 $9.32
J1200 Injection, diphenhydramine hcl, up to 50 mg 2,318 1,567 $5.12
J2550 Injection, promethazine hcl, up to 50 mg 618 382 $4.05
94760 914 779 $3.51
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg 346 286 $3.22
J2060 Injection, lorazepam, 2 mg 2,535 1,776 $3.19
J2765 Injection, metoclopramide hcl, up to 10 mg 1,477 1,255 $3.13
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 993 845 $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 1,100 951 $1.84
A9150 Non-prescription drugs 1,232 972 $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 285 220 $1.31
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 210 172 $1.10
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 30 25 $0.11
A9575 Injection, gadoterate meglumine, 0.1 ml 189 176 $0.00
88313 284 257 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 543 477 $0.00
82075 274 232 $0.00
82800 14 13 $0.00
C9113 Injection, pantoprazole sodium, per vial 85 75 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 143 88 $0.00
J1644 Injection, heparin sodium, per 1000 units 117 41 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 42 40 $0.00
J1171 Injection, hydromorphone, 0.1 mg 123 51 $0.00
77062 26 26 $0.00
Q0243 Injection, casirivimab and imdevimab, 2400 mg 36 32 $0.00
93041 134 106 $0.00
88342 327 294 $0.00
J1630 Injection, haloperidol, up to 5 mg 341 265 $0.00
J1790 Injection, droperidol, up to 5 mg 123 101 $0.00
77063 Screening digital breast tomosynthesis, bilateral 2,466 2,424 $0.00
J7050 Infusion, normal saline solution, 250 cc 1,545 1,229 $0.00
A9270 Non-covered item or service 178 151 $0.00
83615 95 84 $0.00
84703 100 96 $0.00
12001 66 64 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 38 31 $0.00
J1815 Injection, insulin, per 5 units 48 28 $0.00
J2704 Injection, propofol, 10 mg 252 220 $0.00
J8540 Dexamethasone, oral, 0.25 mg 97 83 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 57 37 $0.00
91301 782 677 $0.00
A9585 Injection, gadobutrol, 0.1 ml 13 13 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 13 12 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 16 15 $0.00