Niagara Falls Memorial Medical Center

Niagara Falls Memorial Medical Center was paid $59.86M by Medicaid between Jan 2018 and Dec 2024, across 334 billing codes. Its largest line is G9005, Coordinated care fee, risk adjusted maintenance — 34% of everything it billed.

33Billing provider infoNIAGARA FALLS MEMORIAL MEDICAL CENTER
NIAGARA FALLS, NY 14302

33aNPI1285717298assigned 10/23/2006

33bProvider typeCase Management Agency

28Total paid$59.86M

24GClaims966,427

24DCodes billed334

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Case Management Agency providers in New York

Rank by total paid#26 of 180

Median peer was paid$1.76M

This provider vs. median34×

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	10,522	$281K
2019	91,087	$6.71M
2020	203,600	$16.44M
2021	196,977	$13.79M
2022	166,288	$8.40M
2023	168,551	$8.18M
2024incomplete	129,402	$6.05M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G9005	Coordinated care fee, risk adjusted maintenance	34%	78,220	78,162	$20.27M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	12%	106,619	90,040	$7.38M
90834	Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient	6.2%	33,428	24,174	$3.71M
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	3.6%	15,079	14,308	$2.13M
96361	Intravenous infusion, hydration; each additional hour	3.1%	13,008	7,680	$1.88M
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	2.8%	13,486	12,697	$1.66M
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	2.5%	17,361	14,092	$1.49M
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	2.4%	19,445	18,418	$1.45M
70450	Computed tomography, head or brain; without contrast material	1.9%	3,918	3,806	$1.14M
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	1.7%	8,216	7,656	$1.04M
G9001	Coordinated care fee, initial rate	1.7%	13,707	13,706	$1.02M
G0378	Hospital observation service, per hour	1.4%	809	373	$850K

322 more codes

99282	Emergency department visit for the evaluation and management, low to moderate severity	1.4%	6,358	$848K
80053	Comprehensive metabolic panel	1.2%	38,146	$741K
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	1.2%	5,319	$707K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	1.1%	7,876	$664K
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	<1%	8,248	$593K
97602		<1%	1,315	$561K
T2022	Case management, per month	<1%	1,831	$506K
74177	Computed tomography, abdomen and pelvis; with contrast material	<1%	1,933	$500K
90791	Psychiatric diagnostic evaluation	<1%	3,162	$493K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	8,142	$491K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	5,225	$488K
74176	Computed tomography, abdomen and pelvis; without contrast material	<1%	1,760	$480K
96360	Intravenous infusion, hydration; initial, 31 minutes to 1 hour	<1%	2,063	$361K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	<1%	7,535	$361K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	<1%	677	$358K
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%	4,394	$317K
90792	Psychiatric diagnostic evaluation with medical services	<1%	2,601	$300K
G0444	Annual depression screening, 5 to 15 minutes	<1%	7,641	$296K
99203	Doctor's office visit, new patient (routine)	<1%	3,052	$280K
93306	Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete	<1%	1,934	$271K
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	8,571	$256K
76816	Ultrasound, pregnant uterus, real time with image documentation, follow-up	<1%	3,993	$249K
87491	Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe	<1%	6,661	$243K
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	<1%	7,324	$222K
90853	Group psychotherapy (other than of a multiple-family group)	<1%	9,727	$202K
71275	Computed tomographic angiography, chest, with contrast material	<1%	618	$179K
11042	Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm	<1%	489	$174K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	10,490	$167K
45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s)	<1%	221	$158K
88305	Level IV - Surgical pathology, gross and microscopic examination	<1%	3,349	$139K
99232	Hospital visit by a doctor, follow-up day	<1%	6,498	$132K
87591	Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe	<1%	6,626	$129K
99204	Doctor's office visit, new patient (more involved)	<1%	1,316	$126K
80061	Lipid panel	<1%	14,632	$122K
97161		<1%	1,431	$119K
77067	Screening mammography, bilateral, including computer-aided detection	<1%	2,074	$118K
1159F		<1%	5,149	$113K
83880		<1%	4,083	$110K
87661	Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe	<1%	5,667	$109K
76700	Ultrasound, abdominal, real time with image documentation; complete	<1%	1,151	$108K
76817	Ultrasound, pregnant uterus, real time with image documentation, transvaginal	<1%	1,629	$100K
93975		<1%	489	$97K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	<1%	3,561	$93K
99281	Emergency department visit for the evaluation and management, self-limited or minor	<1%	677	$92K
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour	<1%	756	$86K
84443	Thyroid stimulating hormone (TSH)	<1%	13,025	$79K
83036	Hemoglobin; glycosylated (A1C)	<1%	12,539	$77K
90715		<1%	2,227	$75K
80048	Basic metabolic panel (calcium, ionized)	<1%	4,026	$69K
12001		<1%	177	$67K
76830	Ultrasound, transvaginal	<1%	1,640	$66K
84439		<1%	10,851	$65K
76805	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation	<1%	956	$61K
82607		<1%	7,317	$61K
99222	Initial hospital care, per day, moderate complexity	<1%	1,266	$60K
93976		<1%	699	$56K
86850		<1%	2,249	$54K
90686		<1%	2,121	$53K
88175	Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer	<1%	1,818	$53K
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	<1%	451	$52K
99233	Hospital visit by a doctor, follow-up day (complex)	<1%	1,538	$52K
93015		<1%	876	$51K
93970		<1%	210	$46K
82746		<1%	5,761	$45K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	33,310	$44K
85008		<1%	3,736	$43K
87389	Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies	<1%	4,358	$42K
87624	Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types	<1%	1,140	$40K
71271		<1%	556	$40K
93000		<1%	3,059	$38K
86901		<1%	2,485	$36K
99385		<1%	321	$34K
86900		<1%	2,489	$32K
1160F		<1%	694	$31K
36415	Collection of venous blood by venipuncture	<1%	14,105	$29K
10060		<1%	97	$29K
93971		<1%	411	$28K
71046	Radiologic examination, chest; 2 views	<1%	4,437	$28K
81001		<1%	19,723	$27K
76818		<1%	441	$27K
82728		<1%	2,503	$27K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	5,102	$26K
3074F		<1%	1,088	$26K
99406		<1%	1,076	$25K
86803		<1%	4,892	$23K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	702	$23K
99239	Hospital discharge day management, more than 30 minutes	<1%	655	$22K
82570		<1%	6,820	$21K
77063	Screening digital breast tomosynthesis, bilateral	<1%	1,298	$20K
82043		<1%	6,528	$20K
59025	Fetal non-stress test	<1%	1,263	$20K
97140	Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage)	<1%	923	$18K
76801		<1%	236	$18K
76819	Fetal biophysical profile; without non-stress testing	<1%	319	$17K
87070		<1%	5,581	$17K
96374	Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance	<1%	9,344	$17K
87086	Culture, bacterial; quantitative colony count, urine	<1%	7,315	$17K
45380	Colonoscopy, flexible; with biopsy, single or multiple	<1%	14	$16K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	<1%	24	$16K
99386		<1%	133	$16K
78452	Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress	<1%	108	$15K
76813		<1%	226	$15K
83735		<1%	10,556	$13K
90732		<1%	252	$12K
86780		<1%	1,554	$11K
72110		<1%	1,086	$11K
85610		<1%	7,794	$10K
84153		<1%	736	$10K
86141		<1%	1,219	$10K
70486		<1%	448	$10K
72125	Computed tomography, cervical spine; without contrast material	<1%	701	$9K
87522	Neg quan hep c or qual rna	<1%	222	$9K
87340		<1%	1,350	$9K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	<1%	132	$9K
83540		<1%	2,295	$9K
73562		<1%	1,606	$8K
83550		<1%	2,185	$8K
83655		<1%	611	$8K
86762		<1%	888	$8K
97150	Therapeutic procedure(s), group (2 or more individuals)	<1%	109	$8K
71045	Radiologic examination, chest; single view	<1%	8,248	$7K
99051		<1%	626	$7K
73030		<1%	1,506	$7K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	481	$7K
92228		<1%	81	$7K
3079F		<1%	190	$7K
3075F		<1%	153	$6K
A9500	Technetium tc-99m sestamibi, diagnostic, per study dose	<1%	93	$6K
87088		<1%	2,345	$5K
D0120	Dental checkup, returning patient	<1%	134	$5K
84550		<1%	1,850	$5K
0001A		<1%	173	$5K
85730		<1%	5,521	$5K
73630		<1%	1,495	$5K
0004A		<1%	122	$5K
59430		<1%	39	$5K
82948		<1%	3,942	$5K
97597		<1%	20	$4K
84702		<1%	1,367	$4K
1000F		<1%	689	$4K
73130		<1%	1,320	$4K
87077		<1%	2,130	$4K
90836		<1%	55	$4K
72148	Magnetic resonance imaging, lumbar spine; without contrast material	<1%	13	$4K
99223	Prolong inpt eval add15 m	<1%	58	$4K
72141		<1%	13	$4K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	<1%	1,873	$4K
90661		<1%	115	$4K
0071A		<1%	97	$4K
0002A		<1%	145	$4K
J7120	Ringers lactate infusion, up to 1000 cc	<1%	3,721	$4K
99080		<1%	2,064	$4K
0012A		<1%	189	$4K
0072A		<1%	91	$4K
73610		<1%	1,164	$3K
92250		<1%	56	$3K
99221		<1%	146	$3K
J2785	Injection, regadenoson, 0.1 mg	<1%	40	$3K
85027		<1%	1,674	$3K
76536		<1%	132	$3K
87186		<1%	1,951	$3K
86787		<1%	587	$3K
G0008	Administration of influenza virus vaccine	<1%	241	$3K
0011A		<1%	201	$3K
93005	Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	<1%	6,972	$3K
D1110	Prophylaxis - adult	<1%	55	$2K
76705	Ultrasound, abdominal, real time with image documentation; limited	<1%	37	$2K
85651		<1%	1,524	$2K
84703		<1%	8,246	$2K
82550		<1%	4,872	$2K
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	1,020	$2K
86769		<1%	139	$2K
72100		<1%	689	$2K
86706		<1%	315	$2K
99215	Doctor's office visit, returning patient (complex)	<1%	27	$2K
90670		<1%	37	$2K
73502		<1%	525	$2K
J7040	Infusion, normal saline solution, sterile (500 ml = 1 unit)	<1%	435	$2K
96375	Therapeutic injection; each additional sequential IV push	<1%	7,632	$2K
76641		<1%	118	$2K
88313		<1%	695	$2K
90750		<1%	13	$2K
73110		<1%	452	$2K
G0103	Prostate cancer screening; prostate specific antigen test (psa)	<1%	328	$2K
82652		<1%	156	$2K
84484		<1%	6,326	$2K
73564		<1%	253	$2K
83020		<1%	182	$2K
G0297	Low dose ct scan (ldct) for lung cancer screening	<1%	13	$2K
86580		<1%	93	$2K
90472	Immunization administration, each additional vaccine (list separately)	<1%	332	$2K
81003		<1%	1,377	$2K
72040		<1%	403	$2K
0064A		<1%	38	$2K
83690		<1%	4,942	$2K
99238	Hospital discharge day management, 30 minutes or less	<1%	332	$1K
94760		<1%	364	$1K
86480		<1%	26	$1K
3044F		<1%	133	$1K
88307		<1%	68	$1K
99407		<1%	39	$1K
86038		<1%	268	$1K
0124A		<1%	28	$1K
0054A		<1%	32	$1K
J1050	Injection, medroxyprogesterone acetate, 1 mg	<1%	1,997	$1K
J7050	Infusion, normal saline solution, 250 cc	<1%	3,482	$1K
86704		<1%	141	$1K
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	<1%	19	$985.34
84480		<1%	209	$974.55
90671		<1%	13	$960.05
20605		<1%	25	$943.69
73090		<1%	13	$891.75
74018		<1%	287	$831.94
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	<1%	131	$818.85
83002		<1%	51	$745.88
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%	717	$738.84
93224		<1%	12	$720.00
87040		<1%	1,112	$717.57
83001		<1%	51	$713.66
3077F		<1%	13	$701.09
84100		<1%	199	$698.95
1111F		<1%	160	$682.97
0031A		<1%	17	$680.00
72050		<1%	67	$649.12
0052A		<1%	20	$640.00
96376		<1%	1,467	$635.30
82150		<1%	858	$627.91
80076		<1%	88	$619.41
J2001	Injection, lidocaine hcl for intravenous infusion, 10 mg	<1%	635	$616.95
85007		<1%	937	$583.63
88141		<1%	67	$547.80
85379		<1%	1,225	$503.95
G0009	Administration of pneumococcal vaccine	<1%	43	$482.79
84403		<1%	25	$469.48
82950		<1%	265	$459.71
90662		<1%	33	$452.39
86696		<1%	40	$449.50
83605		<1%	1,655	$423.31
88342		<1%	14	$405.92
J1170	Injection, hydromorphone, up to 4 mg	<1%	3,756	$388.75
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	1,995	$364.34
Q3014	Telehealth originating site facility fee	<1%	27	$342.34
86765		<1%	39	$321.45
82565		<1%	65	$284.70
80320		<1%	4,641	$257.42
84154		<1%	15	$247.99
83921		<1%	12	$233.31
86709		<1%	27	$210.00
73590		<1%	42	$206.19
86735		<1%	37	$184.69
87147		<1%	2,088	$181.31
80329		<1%	2,657	$179.22
84520		<1%	51	$178.07
J7030	Infusion, normal saline solution , 1000 cc	<1%	7,366	$173.04
88300		<1%	36	$148.72
84436		<1%	39	$145.92
82248		<1%	34	$135.69
72072		<1%	13	$126.00
J2405	Injection, ondansetron hydrochloride, per 1 mg	<1%	6,219	$106.73
84425		<1%	13	$106.05
87430		<1%	1,045	$100.27
Q0144	Azithromycin dihydrate, oral, capsules/powder, 1 gram	<1%	532	$87.39
J2930	Injection, methylprednisolone sodium succinate, up to 125 mg	<1%	754	$81.68
J3490	Unclassified drugs	<1%	143	$75.77
73080		<1%	16	$65.89
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	18	$64.58
J1644	Injection, heparin sodium, per 1000 units	<1%	198	$60.89
84460		<1%	12	$55.88
86431		<1%	13	$52.00
J2270	Injection, morphine sulfate, up to 10 mg	<1%	1,225	$51.59
83615		<1%	14	$45.27
99460		<1%	277	$39.08
93226		<1%	12	$35.00
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	2,886	$34.61
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	1,387	$32.99
A9579	Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml	<1%	18	$31.30
82270		<1%	28	$30.60
J0690	Injection, cefazolin sodium, 500 mg	<1%	679	$28.99
82947		<1%	14	$27.51
J2704	Injection, propofol, 10 mg	<1%	944	$25.27
J2060	Injection, lorazepam, 2 mg	<1%	1,966	$22.30
J3411	Injection, thiamine hcl, 100 mg	<1%	166	$15.90
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%	1,518	$15.52
J3370	Injection, vancomycin hcl, 500 mg	<1%	235	$14.98
C9113	Injection, pantoprazole sodium, per vial	<1%	282	$14.32
J3420	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	<1%	744	$12.26
J3475	Injection, magnesium sulfate, per 500 mg	<1%	317	$11.44
71101		<1%	24	$10.61
99462		<1%	96	$10.42
J1200	Injection, diphenhydramine hcl, up to 50 mg	<1%	878	$9.98
86308		<1%	13	$9.56
J3480	Injection, potassium chloride, per 2 meq	<1%	75	$9.22
J3010	Injection, fentanyl citrate, 0.1 mg	<1%	1,593	$9.00
J2250	Injection, midazolam hydrochloride, per 1 mg	<1%	1,721	$7.76
73140		<1%	14	$4.55
J1790	Injection, droperidol, up to 5 mg	<1%	374	$2.74
Q0163	Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen	<1%	396	$2.20
J2765	Injection, metoclopramide hcl, up to 10 mg	<1%	215	$1.84
J1630	Injection, haloperidol, up to 5 mg	<1%	238	$1.48
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%	378	$1.48
J1815	Injection, insulin, per 5 units	<1%	367	$1.12
82009		<1%	55	$1.02
J7512	Prednisone, immediate release or delayed release, oral, 1 mg	<1%	943	$0.50
96127		0%	175	$0.00
87451		0%	22	$0.00
86710		0%	75	$0.00
J7613	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	0%	167	$0.00
91301		0%	27	$0.00
87280		0%	14	$0.00
J8540	Dexamethasone, oral, 0.25 mg	0%	52	$0.00
J3360	Injection, diazepam, up to 5 mg	0%	14	$0.00
87276		0%	17	$0.00
J0131	Injection, acetaminophen, not otherwise specified,10 mg	0%	14	$0.00
J2919	Injection, methylprednisolone sodium succinate, 5 mg	0%	50	$0.00
J1171	Injection, hydromorphone, 0.1 mg	0%	65	$0.00
3078F		0%	138	$0.00
87279		0%	12	$0.00
3016F		0%	68	$0.00
87260		0%	12	$0.00
73565		0%	13	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	12	$0.00
87275		0%	17	$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 officialMEHTA, RAJ (CFO)