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

Tuality Healthcare

Tuality Healthcare was paid $27.82M by Medicaid between Jan 2018 and Dec 2024, across 160 billing codes. Its largest line is 99285, emergency room visit (most serious) — 24% of everything it billed.

33Billing provider infoTUALITY HEALTHCARE
HILLSBORO, OR 97123
33aNPI1275591984assigned 05/02/2006
28Total paid$27.82M
24GClaims486,780
24DCodes billed160
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Multi-Specialty Clinic/Center providers in Oregon

Rank by total paid#3 of 40
Median peer was paid$517K
This provider vs. median54×

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$250K$500K$750K2018201920202021202220232024
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
201862,840$3.45M
201955,614$2.92M
202042,975$2.49M
202158,584$3.26M
202281,813$4.35M
202391,260$5.27M
2024incomplete93,694$6.08M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 24% 17,430 15,861 $6.61M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 22% 34,585 32,062 $6.20M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 19% 72,428 62,025 $5.42M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 19% 21,097 18,873 $5.27M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 4.8% 11,920 10,652 $1.34M
99282 Emergency department visit for the evaluation and management, low to moderate severity 2.6% 7,108 6,583 $717K
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 1.4% 7,344 6,928 $376K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1.0% 7,968 2,793 $287K
96375 Therapeutic injection; each additional sequential IV push <1% 3,298 2,959 $126K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 203 190 $124K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 14,806 13,112 $108K
71046 Radiologic examination, chest; 2 views <1% 1,860 1,622 $89K
148 more codes
80053 Comprehensive metabolic panel <1% 36,660 $73K
96361 Intravenous infusion, hydration; each additional hour <1% 730 $65K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 822 $63K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 47,292 $61K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 69 $53K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 67 $53K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 2,073 $51K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,457 $50K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 2,045 $50K
84443 Thyroid stimulating hormone (TSH) <1% 4,342 $44K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 105 $40K
71045 Radiologic examination, chest; single view <1% 844 $38K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 1,891 $36K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 2,193 $34K
36415 Collection of venous blood by venipuncture <1% 52,878 $33K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 130 $33K
G0396 Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes <1% 906 $33K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 1,388 $29K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 503 $28K
83036 Hemoglobin; glycosylated (A1C) <1% 5,934 $26K
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% 411 $21K
87634 <1% 1,591 $18K
80061 Lipid panel <1% 1,803 $16K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 943 $14K
70450 Computed tomography, head or brain; without contrast material <1% 130 $14K
82728 <1% 1,302 $13K
G0008 Administration of influenza virus vaccine <1% 566 $12K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 678 $11K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 29 $9K
80055 <1% 96 $8K
87086 Culture, bacterial; quantitative colony count, urine <1% 1,487 $7K
86803 <1% 675 $7K
81513 <1% 121 $6K
90686 <1% 316 $5K
90674 <1% 197 $5K
87081 <1% 1,097 $5K
80048 Basic metabolic panel (calcium, ionized) <1% 3,562 $5K
97803 <1% 117 $4K
82607 <1% 407 $4K
51798 <1% 122 $4K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 33 $3K
84484 <1% 4,739 $3K
86900 <1% 278 $3K
85027 <1% 923 $3K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 32 $3K
81003 <1% 11,848 $3K
83690 <1% 7,921 $3K
90656 <1% 108 $3K
73140 <1% 44 $3K
94060 <1% 17 $2K
73562 <1% 90 $2K
20610 <1% 14 $2K
87481 <1% 121 $2K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 412 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 6,301 $2K
81025 <1% 873 $2K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 53 $2K
94761 <1% 34,522 $2K
86403 <1% 347 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 65 $1K
0001A <1% 38 $1K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 1,141 $1K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 121 $1K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 23 $1K
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) <1% 20 $1K
91322 <1% 14 $1K
82746 <1% 106 $1K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 248 $1K
36416 <1% 896 $921.50
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 690 $902.26
88142 <1% 44 $891.36
86592 <1% 269 $880.96
73100 <1% 39 $875.54
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 1,400 $845.36
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 132 $741.84
J3010 Injection, fentanyl citrate, 0.1 mg <1% 654 $691.12
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision <1% 39 $669.16
90480 <1% 27 $647.10
86480 <1% 16 $626.03
97165 <1% 14 $601.27
86787 <1% 65 $577.36
84703 <1% 1,526 $547.28
73030 <1% 14 $525.61
0004A <1% 14 $517.54
88312 <1% 105 $478.90
87653 <1% 21 $475.80
81000 <1% 1,236 $448.56
84439 <1% 78 $397.36
86141 <1% 28 $360.48
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 48 $345.78
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg <1% 52 $336.26
87186 <1% 62 $275.49
J2704 Injection, propofol, 10 mg <1% 1,838 $267.40
87070 <1% 78 $266.00
88313 <1% 105 $239.45
87210 <1% 99 $214.26
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 91 $208.46
85018 <1% 108 $206.50
94760 <1% 20,439 $199.42
85652 <1% 107 $198.27
J7030 Infusion, normal saline solution , 1000 cc <1% 19 $195.86
84481 <1% 12 $173.16
87660 <1% 13 $172.44
87480 <1% 13 $172.44
87510 <1% 13 $172.44
87147 <1% 69 $165.69
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% 578 $159.79
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% 278 $159.20
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% 172 $142.20
Q3014 Telehealth originating site facility fee <1% 103 $120.80
82950 <1% 28 $112.05
86140 <1% 39 $103.30
72170 <1% 14 $101.67
87340 <1% 12 $94.79
80047 <1% 25 $86.52
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 164 $84.61
87205 <1% 43 $79.48
82043 <1% 15 $66.66
82570 <1% 16 $65.84
J7120 Ringers lactate infusion, up to 1000 cc <1% 234 $60.20
J0690 Injection, cefazolin sodium, 500 mg <1% 15 $59.33
J2270 Injection, morphine sulfate, up to 10 mg <1% 49 $50.99
80069 <1% 13 $38.00
84156 <1% 14 $37.82
81001 <1% 1,060 $36.99
82947 <1% 15 $25.62
86308 <1% 13 $23.00
J8540 Dexamethasone, oral, 0.25 mg <1% 15 $19.44
85610 <1% 18 $11.72
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program <1% 3,778 $2.86
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg <1% 21 $1.87
87641 0% 41 $0.00
84702 0% 25 $0.00
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 0% 13 $0.00
86850 0% 276 $0.00
83605 0% 120 $0.00
82077 0% 16 $0.00
86901 0% 278 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 0% 36 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 0% 25 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 0% 113 $0.00
J1040 Injection, methylprednisolone acetate, 80 mg 0% 30 $0.00
87640 0% 41 $0.00
72020 0% 13 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 0% 14 $0.00
83880 0% 20 $0.00
95886 0% 15 $0.00
J1170 Injection, hydromorphone, up to 4 mg 0% 21 $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 officialJAMES-NIELSEN, LORI (PRESIDENT AND CEO)
Same official

Other billing entities under JAMES-NIELSEN, LORI

Full network →
ProviderLocationPaid
Tuality Medical Group LLCHillsboro, OR$11.52M
Tuality HealthcareHillsboro, OR$105K
Tuality HealthcareHillsboro, OR$40K

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