Physician
Mount Carmel Health System
Mount Carmel Health System was paid $5.23M by Medicaid between Jan 2018 and Dec 2024, across 42 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 31% of everything it billed.
33Billing provider infoMOUNT CARMEL HEALTH SYSTEM
COLUMBUS, OH 43213
COLUMBUS, OH 43213
33aNPI1457617235assigned 04/06/2012
33bProvider typeOrthopaedic Surgery Physician
28Total paid$5.23M
24GClaims149,540
24DCodes billed42
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Orthopaedic Surgery Physician providers in Ohio
Rank by total paid#1 of 60
Median peer was paid$13K
This provider vs. median409×
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 | 29,402 | $1.08M | |
| 2019 | 23,602 | $806K | |
| 2020 | 23,358 | $826K | |
| 2021 | 23,673 | $816K | |
| 2022 | 21,273 | $707K | |
| 2023 | 14,151 | $474K | |
| 2024incomplete | 14,081 | $529K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 31% | 44,041 | 39,003 | $1.60M |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 17% | 27,025 | 23,728 | $913K |
| 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 | 10% | 14,880 | 13,985 | $549K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 8.3% | 6,712 | 6,412 | $436K |
| 59025 | Fetal non-stress test | 7.9% | 20,172 | 13,269 | $412K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 3.8% | 6,107 | 5,798 | $199K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.7% | 7,225 | 3,354 | $194K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 3.5% | 301 | 283 | $181K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 2.0% | 2,823 | 2,769 | $106K |
| 99223 | Prolong inpt eval add15 m | 1.5% | 1,072 | 1,032 | $80K |
| 0001A | 1.3% | 1,675 | 1,668 | $66K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.2% | 2,559 | 2,381 | $63K |
30 more codes
| 99222 | Initial hospital care, per day, moderate complexity | 1.2% | 1,169 | $62K |
| 76820 | 1.2% | 3,075 | $61K | |
| 0002A | 1.1% | 1,543 | $60K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 1.0% | 2,083 | $54K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 1,301 | $33K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 940 | $29K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 689 | $24K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,284 | $21K |
| 59430 | <1% | 246 | $12K | |
| 76801 | <1% | 370 | $11K | |
| 59514 | <1% | 14 | $9K | |
| 76818 | <1% | 254 | $7K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 167 | $7K |
| 0012A | <1% | 223 | $7K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 233 | $6K |
| 99219 | <1% | 94 | $5K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 290 | $5K |
| 0011A | <1% | 248 | $4K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 63 | $3K |
| 0031A | <1% | 42 | $2K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 24 | $2K |
| 99226 | <1% | 61 | $2K | |
| 99221 | <1% | 49 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 339 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 43 | $1K |
| 99464 | <1% | 18 | $704.22 | |
| 99241 | <1% | 44 | $603.83 | |
| 99218 | <1% | 15 | $474.00 | |
| 99217 | <1% | 12 | $385.76 | |
| 99024 | 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 officialPRIDAY, ANDREW (TREASURER & CFO)
| Provider | Location | Paid |
|---|---|---|
| Mount Carmel Health System | Columbus, OH | $66.65M |
| Mount Carmel Health System | Westerville, OH | $42.48M |
| Mount Carmel Health System | Grove City, OH | $14.42M |
| Diley Ridge Medical Center | Canal Winchester, OH | $6.17M |
| Mount Carmel Health System | Columbus, OH | $403K |
| Mount Carmel Health System | Columbus, OH | $318K |
| Mount Carmel Health System | Grove City, OH | $180K |
| Mount Carmel Health System | New Albany, OH | $14K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.