Mayo Clinic Health System-Northwest Wisconsin Region, INC.
Mayo Clinic Health System-Northwest Wisconsin Region, INC. was paid $7.51M by Medicaid between Jan 2018 and Dec 2024, across 212 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 24% of everything it billed.
33Billing provider infoMAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.
EAU CLAIRE, WI 54701
EAU CLAIRE, WI 54701
33aNPI1235588831assigned 06/06/2016
33bProvider typeOptician
28Total paid$7.51M
24GClaims338,075
24DCodes billed212
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Optician providers in Wisconsin
Rank by total paid#1 of 40
Median peer was paid$8K
This provider vs. median904×
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 BORTNEM, MARK controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2018 | 54,446 | $1.04M | |
| 2019 | 48,468 | $1.05M | |
| 2020 | 37,316 | $781K | |
| 2021 | 59,655 | $1.05M | |
| 2022 | 54,998 | $1.25M | |
| 2023 | 47,253 | $1.13M | |
| 2024incomplete | 35,939 | $1.21M |
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 | 24% | 50,319 | 46,233 | $1.78M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 14% | 41,575 | 38,137 | $1.04M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 8.3% | 16,828 | 15,647 | $624K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 4.5% | 12,423 | 9,065 | $336K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.0% | 8,097 | 7,507 | $297K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.8% | 6,306 | 5,735 | $287K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.9% | 4,585 | 3,323 | $219K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 2.4% | 8,340 | 7,811 | $184K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.1% | 33,495 | 26,971 | $158K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 2.1% | 14,251 | 12,632 | $155K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.8% | 7,981 | 3,193 | $134K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.8% | 2,497 | 2,285 | $134K |
200 more codes
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.7% | 2,224 | $127K |
| 99223 | Prolong inpt eval add15 m | 1.7% | 2,676 | $125K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.6% | 4,347 | $123K |
| 99283 | Emergency room visit (moderate) | 1.3% | 3,901 | $99K |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.2% | 1,844 | $89K |
| 99232 | Hospital visit by a doctor, follow-up day | 1.2% | 8,575 | $87K |
| 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 | 1.1% | 1,294 | $83K |
| 87631 | 1.1% | 741 | $79K | |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 3,699 | $74K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,212 | $68K |
| 92015 | Determination of refractive state | <1% | 8,826 | $59K |
| 67028 | Intravitreal injection of a pharmacologic agent | <1% | 1,286 | $58K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 1,572 | $53K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 1,401 | $51K |
| 92134 | <1% | 4,855 | $50K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 6,690 | $49K |
| 71045 | Radiologic examination, chest; single view | <1% | 13,446 | $45K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 637 | $39K |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 1,161 | $38K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 299 | $36K |
| 88307 | <1% | 633 | $36K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 1,362 | $32K |
| 90686 | <1% | 3,704 | $30K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 419 | $29K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 716 | $26K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 409 | $25K |
| 0002A | <1% | 719 | $24K | |
| 90961 | <1% | 862 | $23K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,804 | $21K |
| 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% | 374 | $21K |
| 99221 | <1% | 439 | $19K | |
| 0001A | <1% | 616 | $18K | |
| 0004A | <1% | 517 | $18K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 3,490 | $17K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 170 | $17K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,178 | $17K |
| 92060 | <1% | 422 | $16K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 541 | $15K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,033 | $14K |
| 90962 | <1% | 378 | $13K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 222 | $12K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 109 | $11K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 153 | $11K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 407 | $10K |
| 0071A | <1% | 283 | $10K | |
| 90837 | Psychotherapy session, about an hour | <1% | 117 | $9K |
| 99243 | <1% | 147 | $9K | |
| 0072A | <1% | 250 | $9K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 235 | $9K |
| 99245 | <1% | 72 | $8K | |
| 80053 | Comprehensive metabolic panel | <1% | 1,174 | $7K |
| 11721 | <1% | 846 | $7K | |
| 49083 | <1% | 30 | $7K | |
| 92341 | <1% | 223 | $6K | |
| 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% | 740 | $6K |
| 73630 | <1% | 400 | $6K | |
| 81025 | <1% | 826 | $6K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 27 | $6K |
| 95886 | <1% | 216 | $6K | |
| 95117 | <1% | 1,648 | $5K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 111 | $5K |
| 88342 | <1% | 266 | $5K | |
| 99205 | Prolong outpt/office vis | <1% | 88 | $5K |
| 99460 | <1% | 58 | $5K | |
| 81001 | <1% | 1,941 | $5K | |
| 0054A | <1% | 137 | $5K | |
| 64483 | <1% | 43 | $5K | |
| 90656 | <1% | 293 | $5K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 147 | $5K |
| 92567 | <1% | 305 | $5K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 113 | $4K |
| 0064A | <1% | 118 | $4K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 830 | $4K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 54 | $4K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 117 | $4K |
| 84165 | <1% | 483 | $4K | |
| 81003 | <1% | 1,987 | $3K | |
| 90670 | <1% | 706 | $3K | |
| 92551 | <1% | 226 | $3K | |
| 93294 | <1% | 590 | $3K | |
| 93000 | <1% | 206 | $3K | |
| 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% | 1,805 | $2K |
| 87510 | <1% | 291 | $2K | |
| 87660 | <1% | 291 | $2K | |
| 88142 | <1% | 96 | $2K | |
| 87480 | <1% | 274 | $2K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 498 | $2K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 55 | $2K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 54 | $2K |
| 94060 | <1% | 326 | $2K | |
| 99242 | <1% | 39 | $2K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 39 | $2K |
| 92235 | <1% | 25 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 27 | $1K |
| 90698 | <1% | 517 | $1K | |
| 88304 | <1% | 197 | $1K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 50 | $1K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 159 | $1K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 14 | $1K |
| 73610 | <1% | 77 | $1K | |
| 92133 | <1% | 50 | $1K | |
| 99217 | <1% | 60 | $1K | |
| 88141 | <1% | 47 | $996.15 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 26 | $991.29 |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 31 | $990.00 |
| 0003A | <1% | 34 | $923.20 | |
| 87634 | <1% | 13 | $901.29 | |
| 93295 | <1% | 37 | $827.91 | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 14 | $768.80 |
| 83655 | <1% | 57 | $753.85 | |
| 94726 | <1% | 177 | $701.57 | |
| 93227 | <1% | 51 | $679.80 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,169 | $677.41 |
| 73564 | <1% | 30 | $659.79 | |
| 99188 | <1% | 54 | $659.22 | |
| 86334 | <1% | 103 | $588.64 | |
| 99442 | <1% | 46 | $580.41 | |
| 90680 | <1% | 156 | $553.93 | |
| 99443 | <1% | 56 | $544.14 | |
| 92083 | <1% | 36 | $539.54 | |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 13 | $533.78 |
| 95812 | <1% | 12 | $529.43 | |
| 0031A | <1% | 13 | $507.12 | |
| 94729 | <1% | 190 | $506.01 | |
| 0124A | <1% | 13 | $467.12 | |
| 0051A | <1% | 13 | $465.35 | |
| 87070 | <1% | 288 | $462.13 | |
| 90697 | <1% | 51 | $395.70 | |
| 90685 | <1% | 126 | $379.55 | |
| 99152 | <1% | 33 | $373.51 | |
| 82947 | <1% | 172 | $371.07 | |
| 90677 | <1% | 26 | $363.14 | |
| 86803 | <1% | 79 | $286.11 | |
| 92558 | <1% | 13 | $274.16 | |
| 90935 | Hemodialysis procedure with single evaluation by a physician | <1% | 39 | $269.12 |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 173 | $259.46 |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 13 | $239.44 |
| 85027 | <1% | 220 | $234.43 | |
| 73110 | <1% | 13 | $232.52 | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 12 | $217.26 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 19 | $214.94 |
| 85018 | <1% | 187 | $213.01 | |
| 17110 | <1% | 19 | $202.93 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 12 | $189.04 |
| 85060 | <1% | 12 | $179.55 | |
| 74018 | <1% | 14 | $148.93 | |
| 99219 | <1% | 13 | $133.58 | |
| 99441 | <1% | 28 | $121.41 | |
| 96161 | <1% | 26 | $108.80 | |
| 77002 | <1% | 15 | $102.29 | |
| 83690 | <1% | 13 | $91.61 | |
| 90633 | <1% | 30 | $90.73 | |
| 90744 | <1% | 29 | $77.84 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 248 | $77.66 |
| 64566 | <1% | 35 | $71.93 | |
| 86140 | <1% | 156 | $41.44 | |
| 0764T | <1% | 390 | $22.00 | |
| 93325 | <1% | 13 | $15.80 | |
| 86769 | <1% | 57 | $14.23 | |
| G9717 | Documentation stating the patient has had a diagnosis of bipolar disorder | 0% | 2,039 | $0.00 |
| 94760 | 0% | 71 | $0.00 | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 0% | 100 | $0.00 |
| 87340 | 0% | 93 | $0.00 | |
| 86762 | 0% | 54 | $0.00 | |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 0% | 120 | $0.00 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 0% | 180 | $0.00 |
| 3074F | 0% | 149 | $0.00 | |
| 91307 | 0% | 551 | $0.00 | |
| 86901 | 0% | 31 | $0.00 | |
| 82728 | 0% | 77 | $0.00 | |
| 83735 | 0% | 19 | $0.00 | |
| G8432 | Depression screening not documented, reason not given | 0% | 33 | $0.00 |
| 91305 | 0% | 190 | $0.00 | |
| 91306 | 0% | 114 | $0.00 | |
| 86850 | 0% | 58 | $0.00 | |
| 85652 | 0% | 14 | $0.00 | |
| 91303 | 0% | 30 | $0.00 | |
| 86780 | 0% | 90 | $0.00 | |
| G0123 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision | 0% | 35 | $0.00 |
| 87077 | 0% | 79 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 13 | $0.00 |
| 82950 | 0% | 30 | $0.00 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 0% | 3,791 | $0.00 |
| 84439 | 0% | 68 | $0.00 | |
| 80061 | Lipid panel | 0% | 216 | $0.00 |
| 91300 | 0% | 1,896 | $0.00 | |
| 84702 | 0% | 56 | $0.00 | |
| 80364 | 0% | 61 | $0.00 | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 0% | 181 | $0.00 |
| 84450 | 0% | 65 | $0.00 | |
| 87186 | 0% | 34 | $0.00 | |
| 87653 | 0% | 74 | $0.00 | |
| 3078F | 0% | 111 | $0.00 | |
| 84460 | 0% | 61 | $0.00 | |
| 85610 | 0% | 47 | $0.00 | |
| 82565 | 0% | 127 | $0.00 | |
| 91312 | 0% | 13 | $0.00 | |
| 86900 | 0% | 44 | $0.00 | |
| 99421 | 0% | 26 | $0.00 | |
| 0502F | 0% | 12 | $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 officialBORTNEM, MARK (CFO)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.