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

Mercy Hospitals East Communities

Mercy Hospitals East Communities was paid $56.55M by Medicaid between Jan 2018 and Dec 2024, across 191 billing codes. Its largest line is Y7506, — 16% of everything it billed.

33Billing provider infoMERCY HOSPITALS EAST COMMUNITIES
SAINT LOUIS, MO 63141
33aNPI1427098169assigned 06/08/2006
33bProvider typeFamily Medicine Physician
28Total paid$56.55M
24GClaims476,120
24DCodes billed191
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Family Medicine Physician providers in Missouri

Rank by total paid#1 of 911
Median peer was paid$16K
This provider vs. median3,595×

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$1.0M$2.0M2018201920202021202220232024
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
201865,076$14.06M
201961,876$12.75M
202054,861$4.67M
202168,695$2.07M
202277,413$6.57M
202383,256$8.69M
2024incomplete64,943$7.75M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
Y7506 16% 37,986 32,087 $9.24M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 16% 53,063 42,674 $9.06M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 12% 45,032 35,922 $6.65M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 10% 42,349 33,768 $5.73M
X4011 State-specific procedure code 6.6% 19,040 18,025 $3.75M
85025 Blood count; complete (CBC), automated, and automated differential WBC count 3.9% 54,809 44,469 $2.23M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 2.8% 25,009 22,582 $1.58M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 2.6% 7,469 6,684 $1.46M
80053 Comprehensive metabolic panel 2.5% 43,162 35,689 $1.42M
0202U Oncology (prostate), multianalyte, gene expression profiling 1.9% 3,687 3,632 $1.06M
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 1.8% 3,129 1,557 $1.02M
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 1.6% 2,100 2,021 $882K
179 more codes
59025 Fetal non-stress test 1.6% 4,483 $879K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1.3% 1,357 $739K
55175 1.2% 570 $679K
93325 1.1% 1,690 $638K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 4,364 $542K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 9,604 $539K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 12,369 $526K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 1,577 $452K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 3,163 $436K
93320 <1% 1,032 $431K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 120 $350K
81002 <1% 7,139 $306K
74018 <1% 2,673 $253K
X4003 <1% 4,285 $243K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 1,451 $242K
54304 <1% 136 $237K
76770 <1% 2,675 $231K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 2,179 $210K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 201 $189K
99213 Doctor's office visit, returning patient (routine) <1% 2,930 $177K
94060 <1% 1,185 $177K
36591 <1% 3,366 $175K
90686 <1% 4,247 $172K
81001 <1% 3,438 $171K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 1,695 $167K
V2020 Frames, purchases <1% 1,897 $129K
90698 <1% 2,221 $117K
90853 Group psychotherapy (other than of a multiple-family group) <1% 836 $108K
90670 <1% 1,698 $108K
87086 Culture, bacterial; quantitative colony count, urine <1% 2,230 $103K
83036 Hemoglobin; glycosylated (A1C) <1% 2,366 $98K
80061 Lipid panel <1% 1,452 $89K
D7999 <1% 662 $89K
92567 <1% 1,762 $87K
36415 Collection of venous blood by venipuncture <1% 2,556 $84K
G0378 Hospital observation service, per hour <1% 294 $81K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 143 $75K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 769 $72K
87070 <1% 707 $70K
V2784 Lens, polycarbonate or equal, any index, per lens <1% 1,150 $70K
J3490 Unclassified drugs <1% 3,116 $69K
84443 Thyroid stimulating hormone (TSH) <1% 1,224 $64K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 867 $60K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 840 $59K
84450 <1% 1,067 $58K
84460 <1% 1,064 $57K
87631 <1% 176 $56K
96375 Therapeutic injection; each additional sequential IV push <1% 1,495 $55K
84439 <1% 841 $54K
71046 Radiologic examination, chest; 2 views <1% 705 $54K
90744 <1% 993 $54K
90633 <1% 1,089 $53K
54161 <1% 25 $51K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 628 $48K
90681 <1% 881 $47K
81003 <1% 672 $45K
90651 <1% 705 $43K
83655 <1% 1,240 $41K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 413 $40K
53605 <1% 54 $37K
86140 <1% 425 $37K
80081 <1% 491 $35K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 232 $33K
85018 <1% 1,098 $33K
85014 <1% 1,098 $33K
94760 <1% 630 $29K
96367 <1% 887 $29K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 721 $28K
99214 Doctor's office visit, returning patient (more involved) <1% 529 $28K
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% 3,077 $26K
87807 <1% 85 $22K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens <1% 344 $21K
87081 <1% 1,115 $21K
92555 <1% 220 $21K
94761 <1% 29 $20K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 54 $19K
74019 <1% 228 $18K
87481 <1% 87 $18K
87511 <1% 71 $18K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 168 $17K
90734 <1% 219 $16K
83516 <1% 46 $15K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 393 $15K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 81 $14K
82397 <1% 141 $14K
92587 <1% 215 $13K
80048 Basic metabolic panel (calcium, ionized) <1% 89 $11K
0072A <1% 293 $11K
94010 <1% 561 $10K
82784 <1% 92 $10K
87799 <1% 33 $9K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 115 $9K
X4006 <1% 14 $9K
G0381 Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) <1% 98 $9K
92552 <1% 52 $8K
Y7507 <1% 119 $8K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms <1% 46 $7K
82728 <1% 295 $7K
95819 <1% 24 $6K
92015 Determination of refractive state <1% 851 $6K
15852 <1% 13 $6K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 158 $6K
85610 <1% 53 $6K
85652 <1% 50 $6K
87088 <1% 164 $6K
71045 Radiologic examination, chest; single view <1% 115 $6K
0071A <1% 197 $5K
90707 <1% 122 $5K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 174 $5K
90716 <1% 127 $4K
D2930 Prefabricated stainless steel crown - primary tooth <1% 17 $4K
86580 <1% 67 $4K
87428 <1% 163 $4K
84702 <1% 510 $4K
81025 <1% 326 $3K
92579 <1% 40 $3K
90710 <1% 44 $3K
0240U <1% 34 $3K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 12 $3K
73120 <1% 52 $3K
0052A <1% 95 $3K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens <1% 39 $3K
90715 <1% 36 $3K
86803 <1% 44 $3K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 31 $3K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 28 $3K
54162 <1% 13 $3K
92582 <1% 29 $3K
90656 <1% 569 $3K
74455 <1% 12 $3K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder <1% 32 $2K
90677 <1% 427 $2K
D7140 Extraction, erupted tooth or exposed root <1% 17 $2K
0001A <1% 56 $2K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 29 $2K
90620 <1% 29 $2K
82950 <1% 70 $2K
0002A <1% 54 $2K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 54 $2K
84466 <1% 251 $2K
86900 <1% 58 $2K
96417 <1% 57 $2K
82607 <1% 198 $1K
95812 <1% 13 $1K
83037 <1% 219 $1K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc <1% 36 $1K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 31 $1K
82746 <1% 180 $1K
93308 <1% 23 $950.74
85027 <1% 28 $927.66
83540 <1% 251 $869.65
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 13 $763.88
83615 <1% 252 $722.38
0124A <1% 35 $680.00
86901 <1% 58 $529.66
84484 <1% 43 $457.02
81513 <1% 48 $456.40
0003A <1% 19 $440.00
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% 139 $373.10
87430 <1% 93 $358.81
D1120 Dental cleaning, child <1% 14 $344.57
83880 <1% 13 $333.52
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 44 $331.32
82657 <1% 78 $228.85
84703 <1% 37 $194.20
90480 <1% 17 $190.16
D1110 Prophylaxis - adult <1% 33 $168.08
90619 <1% 29 $163.62
54450 <1% 19 $146.65
83690 <1% 25 $57.82
87653 <1% 16 $28.07
J7050 Infusion, normal saline solution, 250 cc <1% 38 $1.47
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 0% 188 $0.00
G0008 Administration of influenza virus vaccine 0% 356 $0.00
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 0% 16 $0.00
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 0% 14 $0.00
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 0% 12 $0.00
90662 0% 44 $0.00
88302 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 officialSCOFFIC, DENISE (VICE PRESIDENT FINANCE)
Same official

Other billing entities under SCOFFIC, DENISE

Full network →
ProviderLocationPaid
Mercy Hospitals East CommunitiesSaint Louis, MO$2.59M
Mercy Health Services, LLCSaint Louis, MO$152K
Mercy Health Services LLCSaint Louis, MO$147K
Mercy Health Services LLCSaint Louis, MO$37K
Mercy Hospitals East CommunitiesSaint Louis, MO$15K
Mercy Health Services, LLCSt. Louis, MO$15K
Mercy Hospitals East CommunitiesSaint Louis, MO$883.43

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