Hospital
Grafton City Hospital INC
Grafton City Hospital INC was paid $6.45M by Medicaid between Jan 2018 and Dec 2024, across 97 billing codes. Its largest line is 99283, emergency room visit (moderate) — 14% of everything it billed.
33Billing provider infoGRAFTON CITY HOSPITAL INC
GRAFTON, WV 26354
GRAFTON, WV 26354
33aNPI1265484893assigned 05/16/2006
33bProvider typeCritical Access Hospital
28Total paid$6.45M
24GClaims131,172
24DCodes billed97
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Critical Access Hospital providers in West Virginia
Rank by total paid#10 of 24
Median peer was paid$3.57M
This provider vs. median1.8×
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 | |
|---|---|---|---|
| 2018 | 20,503 | $1.14M | |
| 2019 | 13,653 | $772K | |
| 2020 | 26,794 | $1.53M | |
| 2021 | 25,247 | $1.11M | |
| 2022 | 18,332 | $671K | |
| 2023 | 15,326 | $657K | |
| 2024incomplete | 11,317 | $570K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 14% | 8,742 | 6,892 | $905K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 11% | 5,608 | 4,451 | $740K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 6.2% | 3,940 | 3,584 | $399K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.5% | 1,857 | 1,360 | $292K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 4.0% | 1,150 | 673 | $260K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 3.9% | 2,839 | 794 | $250K |
| 80053 | Comprehensive metabolic panel | 3.9% | 6,512 | 5,257 | $250K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.8% | 10,142 | 7,563 | $247K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.5% | 5,405 | 4,803 | $226K |
| 36415 | Collection of venous blood by venipuncture | 2.4% | 13,250 | 9,388 | $154K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 2.3% | 2,905 | 2,435 | $151K |
| 80306 | 2.2% | 748 | 529 | $144K |
85 more codes
| 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 | 1.8% | 1,070 | $119K |
| 70450 | Computed tomography, head or brain; without contrast material | 1.8% | 531 | $117K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.6% | 2,062 | $104K |
| 84443 | Thyroid stimulating hormone (TSH) | 1.6% | 2,080 | $103K |
| 80076 | 1.6% | 1,976 | $100K | |
| 71046 | Radiologic examination, chest; 2 views | 1.5% | 1,849 | $94K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 1.4% | 1,874 | $88K |
| 94760 | 1.3% | 5,127 | $86K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.3% | 2,384 | $83K |
| 80048 | Basic metabolic panel (calcium, ionized) | 1.3% | 3,616 | $81K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 1.1% | 1,014 | $68K |
| 83880 | 1.0% | 992 | $67K | |
| 96375 | Therapeutic injection; each additional sequential IV push | 1.0% | 1,346 | $66K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 220 | $62K |
| 81001 | <1% | 2,477 | $61K | |
| 80061 | Lipid panel | <1% | 1,044 | $59K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 5,152 | $54K |
| 83735 | <1% | 3,391 | $52K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 827 | $51K |
| 84484 | <1% | 2,512 | $50K | |
| 82550 | <1% | 2,082 | $44K | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 545 | $41K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 772 | $40K |
| 83605 | <1% | 1,321 | $39K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,422 | $37K |
| 84100 | <1% | 3,159 | $36K | |
| 87634 | <1% | 314 | $35K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,179 | $34K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 1,212 | $29K |
| 83690 | <1% | 981 | $29K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 705 | $27K |
| 71045 | Radiologic examination, chest; single view | <1% | 822 | $24K |
| 82553 | <1% | 1,086 | $23K | |
| 85610 | <1% | 1,102 | $22K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 755 | $22K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 253 | $21K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 45 | $19K |
| 81025 | <1% | 448 | $19K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 382 | $19K |
| 82150 | <1% | 467 | $17K | |
| 71250 | <1% | 42 | $14K | |
| 85730 | <1% | 660 | $13K | |
| 81003 | <1% | 418 | $13K | |
| 87806 | <1% | 136 | $12K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 652 | $11K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 179 | $10K |
| 87077 | <1% | 423 | $10K | |
| 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% | 196 | $10K |
| 86705 | <1% | 112 | $10K | |
| 87186 | <1% | 396 | $10K | |
| 97162 | <1% | 98 | $9K | |
| 86803 | <1% | 117 | $9K | |
| 86707 | <1% | 117 | $9K | |
| 73564 | <1% | 148 | $9K | |
| 86704 | <1% | 114 | $9K | |
| 73630 | <1% | 149 | $9K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 14 | $9K |
| 86706 | <1% | 115 | $9K | |
| 87350 | <1% | 115 | $9K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 159 | $8K |
| 87340 | <1% | 115 | $8K | |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | <1% | 51 | $7K |
| 74019 | <1% | 47 | $7K | |
| 96376 | <1% | 140 | $7K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 24 | $6K |
| 72110 | <1% | 75 | $6K | |
| 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% | 742 | $5K |
| 74022 | <1% | 31 | $5K | |
| 84145 | <1% | 144 | $5K | |
| 84703 | <1% | 73 | $5K | |
| 87040 | <1% | 101 | $4K | |
| 85379 | <1% | 210 | $4K | |
| 86140 | <1% | 237 | $4K | |
| 73130 | <1% | 55 | $3K | |
| 73610 | <1% | 55 | $3K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 39 | $3K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 67 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 42 | $2K |
| 87070 | <1% | 45 | $2K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 738 | $1K |
| 73030 | <1% | 12 | $595.18 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 12 | $484.30 |
| 0001A | <1% | 19 | $227.52 | |
| 87081 | <1% | 15 | $172.35 | |
| 91300 | <1% | 29 | $0.02 |
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 officialLILLEY, JEFFREY (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Grafton City Hospital INC | Grafton, WV | $4.42M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.