Hospital
Prohealth Oconomowoc Memorial Hospital, INC.
Prohealth Oconomowoc Memorial Hospital, INC. was paid $2.33M by Medicaid between Jan 2018 and Dec 2024, across 116 billing codes. Its largest line is 99283, emergency room visit (moderate) — 20% of everything it billed.
33Billing provider infoPROHEALTH OCONOMOWOC MEMORIAL HOSPITAL, INC.
OCONOMOWOC, WI 53066
OCONOMOWOC, WI 53066
33aNPI1366420531assigned 01/06/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$2.33M
24GClaims156,431
24DCodes billed116
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Wisconsin
Rank by total paid#34 of 60
Median peer was paid$2.90M
This provider vs. median0.8×
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 | 16,869 | $345K | |
| 2019 | 18,553 | $341K | |
| 2020 | 18,767 | $286K | |
| 2021 | 25,778 | $318K | |
| 2022 | 25,518 | $309K | |
| 2023 | 30,007 | $382K | |
| 2024incomplete | 20,939 | $346K |
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 | 20% | 8,856 | 7,467 | $463K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 9.6% | 4,969 | 4,229 | $223K |
| 96361 | Intravenous infusion, hydration; each additional hour | 8.7% | 1,880 | 1,258 | $203K |
| 80053 | Comprehensive metabolic panel | 8.0% | 10,363 | 7,314 | $187K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 5.8% | 2,874 | 1,407 | $134K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 4.6% | 1,968 | 1,642 | $107K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 4.2% | 1,450 | 1,274 | $99K |
| 70450 | Computed tomography, head or brain; without contrast material | 4.0% | 1,398 | 1,228 | $94K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.8% | 2,037 | 1,581 | $65K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 2.5% | 886 | 605 | $59K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 2.5% | 10,274 | 7,440 | $59K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 2.2% | 1,454 | 1,263 | $51K |
104 more codes
| 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 | 2.0% | 789 | $46K |
| 80048 | Basic metabolic panel (calcium, ionized) | 1.5% | 2,266 | $34K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 1.4% | 1,291 | $33K |
| 84703 | 1.3% | 2,980 | $31K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 1.3% | 1,398 | $30K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 1.2% | 1,371 | $28K |
| 83735 | 1.2% | 5,828 | $28K | |
| 84484 | <1% | 2,408 | $21K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 479 | $19K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 358 | $18K |
| G0378 | Hospital observation service, per hour | <1% | 1,129 | $17K |
| 80050 | General health panel | <1% | 2,209 | $17K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 5,362 | $16K |
| 85610 | <1% | 954 | $14K | |
| 85027 | <1% | 2,915 | $14K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 383 | $13K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 970 | $13K |
| 83690 | <1% | 2,553 | $13K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,671 | $13K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 797 | $12K |
| 82947 | <1% | 1,744 | $11K | |
| 81001 | <1% | 3,232 | $9K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 382 | $9K |
| 81003 | <1% | 3,089 | $9K | |
| 41899 | Unlisted procedure, dentoalveolar structures | <1% | 30 | $9K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 662 | $8K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 115 | $7K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 67 | $7K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 1,531 | $7K |
| 85379 | <1% | 808 | $6K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,336 | $5K |
| 84100 | <1% | 1,610 | $5K | |
| 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% | 121 | $5K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 90 | $5K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 78 | $4K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 129 | $4K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 4,202 | $4K |
| 80061 | Lipid panel | <1% | 294 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 111 | $3K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 602 | $3K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,906 | $3K |
| 87428 | <1% | 82 | $2K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 40 | $2K |
| 80081 | <1% | 12 | $2K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 206 | $2K |
| 80320 | <1% | 774 | $2K | |
| 82728 | <1% | 148 | $2K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 15,693 | $1K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 4,516 | $1K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 32 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 15 | $1K |
| 87070 | <1% | 42 | $983.26 | |
| 86850 | <1% | 162 | $974.24 | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | <1% | 22 | $855.82 |
| 84439 | <1% | 108 | $768.03 | |
| 76642 | <1% | 27 | $688.90 | |
| 86803 | <1% | 34 | $667.41 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 26 | $625.59 |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 16 | $614.52 |
| 83540 | <1% | 87 | $536.87 | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 39 | $512.85 |
| 86900 | <1% | 192 | $423.93 | |
| 81025 | <1% | 29 | $411.89 | |
| 84702 | <1% | 36 | $363.46 | |
| 83550 | <1% | 85 | $354.69 | |
| 83605 | <1% | 25 | $351.51 | |
| 83880 | <1% | 16 | $344.06 | |
| 87040 | <1% | 52 | $343.26 | |
| 86901 | <1% | 197 | $324.00 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 4,311 | $281.47 |
| 87186 | <1% | 59 | $278.05 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 13 | $254.79 |
| 82550 | <1% | 51 | $250.43 | |
| 84146 | <1% | 13 | $233.21 | |
| 96376 | <1% | 773 | $152.77 | |
| 87077 | <1% | 16 | $105.92 | |
| 82570 | <1% | 17 | $60.97 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,892 | $48.42 |
| 86140 | <1% | 14 | $43.61 | |
| 84132 | <1% | 15 | $39.61 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | <1% | 91 | $5.88 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 636 | $4.12 |
| 80329 | <1% | 87 | $2.06 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 1,400 | $1.83 |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 1,567 | $1.09 |
| A9270 | Non-covered item or service | <1% | 686 | $1.00 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 1,702 | $0.89 |
| J7999 | Compounded drug, not otherwise classified | <1% | 616 | $0.73 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 3,186 | $0.35 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,962 | $0.35 |
| J2704 | Injection, propofol, 10 mg | <1% | 78 | $0.16 |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | <1% | 62 | $0.03 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 367 | $0.00 |
| A9585 | Injection, gadobutrol, 0.1 ml | 0% | 169 | $0.00 |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 139 | $0.00 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 0% | 55 | $0.00 |
| 94760 | 0% | 82 | $0.00 | |
| 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 | 0% | 62 | $0.00 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 0% | 1,390 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 303 | $0.00 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 0% | 67 | $0.00 |
| J1644 | Injection, heparin sodium, per 1000 units | 0% | 36 | $0.00 |
| J3475 | Injection, magnesium sulfate, per 500 mg | 0% | 127 | $0.00 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 0% | 15 | $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 officialEDWARDS, SUSAN (CEO)
| Provider | Location | Paid |
|---|---|---|
| Prohealth Waukesha Memorial Hospital, INC. | Waukesha, WI | $21.39M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.