Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PROSPECT CCMC, LLC

NPI: 1457715146 · CHESTER, PA 19013 · General Acute Care Hospital · NPI assigned 04/08/2016

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more

$40.89M
Total Medicaid Paid
310,908
Total Claims
268,793
Beneficiaries
246
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date04/08/2016

Related Entities

Other providers sharing the same authorized official: ELDERS, ROBERT

ProviderCityStateTotal Paid
PROSPECT WATERBURY, INC. WATERBURY CT $84.62M
PROSPECT MANCHESTER HOSPITAL, INC. MANCHESTER CT $69.20M
PROSPECT CHARTERCARE RWMC, LLC PROVIDENCE RI $57.10M
PROSPECT CT MEDICAL FOUNDATION, INC. MANCHESTER CT $34.07M
PROSPECT ROCKVILLE HOSPITAL, INC. VERNON CT $30.06M
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $10.94M
PROSPECT DCMH, LLC DREXEL HILL PA $10.37M
PROSPECT CCMC, LLC CHESTER PA $5.46M
ALTA LOS ANGELES HOSPITALS, INC. LOS ANGELES CA $5.42M
PROSPECT CCMC, LLC CHESTER PA $5.03M
PROSPECT CCMC, LLC CHESTER PA $3.71M
PROSPECT CHARTERCARE PHYSICIANS, LLC CRANSTON RI $2.31M
PROSPECT ECHN HOME HEALTH, INC. VERNON CT $1.75M
PROSPECT WATERBURY HOME HEALTH, INC. WATERTOWN CT $1.30M
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $1.22M
ALTA NEWPORT HOSPITAL, LLC TUSTIN CA $1.16M
PROSPECT HEALTH ACCESS NETWORK, INC. CRUM LYNNE PA $924K
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $872K
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $858K
PROSPECT HEALTH ACCESS NETWORK, INC. DREXEL HILL PA $815K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,557 $154K
2019 5,744 $513K
2020 44,876 $4.86M
2021 110,798 $15.81M
2022 33,950 $6.38M
2023 53,849 $7.46M
2024 60,134 $5.72M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99283 Emergency department visit for the evaluation and management, moderate severity 32,840 31,507 $9.85M
99284 Emergency department visit for the evaluation and management, high severity 25,178 24,138 $7.20M
G0378 Hospital observation service, per hour 3,162 2,848 $7.06M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 26,203 24,949 $6.90M
99281 Emergency department visit for the evaluation and management, self-limited or minor 6,173 5,908 $1.71M
A0429 Ambulance service, basic life support, emergency transport (bls-emergency) 2,154 1,891 $756K
A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) 1,503 1,343 $603K
99282 Emergency department visit for the evaluation and management, low to moderate severity 2,060 1,932 $579K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 3,109 2,975 $387K
97530 Therapeutic activities, direct patient contact, each 15 minutes 5,566 2,183 $294K
77067 Screening mammography, bilateral, including computer-aided detection 1,547 1,531 $280K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 914 897 $231K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,221 2,141 $215K
62323 130 130 $203K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 4,352 4,049 $173K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 307 304 $166K
59025 Fetal non-stress test 2,684 1,407 $164K
74177 Computed tomography, abdomen and pelvis; with contrast material 1,041 1,009 $162K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 2,495 793 $152K
97597 1,092 626 $147K
97161 578 541 $142K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 1,015 1,006 $136K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,246 1,163 $133K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 4,627 1,455 $128K
95810 Polysomnography; sleep staging with 4 or more additional parameters 158 151 $122K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 239 228 $118K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 312 307 $109K
76700 Ultrasound, abdominal, real time with image documentation; complete 769 757 $100K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 5,241 4,899 $95K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 155 150 $84K
97535 Self-care/home management training, each 15 minutes 2,002 1,374 $80K
77063 Screening digital breast tomosynthesis, bilateral 1,534 1,518 $75K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 1,947 724 $74K
76830 Ultrasound, transvaginal 665 658 $73K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 6,153 5,491 $65K
76801 663 634 $60K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 4,996 4,806 $58K
77066 Tomosynthesis, mammo 293 286 $53K
36415 Collection of venous blood by venipuncture 12,342 10,505 $52K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 451 377 $51K
74183 53 51 $50K
76536 364 356 $49K
97164 482 462 $45K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 638 630 $45K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,242 1,189 $44K
71046 Radiologic examination, chest; 2 views 1,924 1,843 $44K
72100 675 661 $43K
76813 301 294 $42K
93971 329 319 $42K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 291 275 $42K
76642 424 417 $41K
73564 862 647 $41K
97010 2,170 728 $38K
71260 Computed tomography, thorax, diagnostic; with contrast material 297 286 $38K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 310 197 $36K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 5,398 4,841 $36K
93017 311 308 $36K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,266 1,012 $35K
70551 Magnetic resonance imaging, brain; without contrast material 111 109 $35K
71250 250 246 $34K
97162 498 474 $32K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 783 675 $32K
70450 Computed tomography, head or brain; without contrast material 1,236 1,145 $32K
80053 Comprehensive metabolic panel 8,667 7,828 $31K
93970 158 153 $30K
0002A 521 518 $29K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 91 89 $27K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 260 229 $27K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 25 24 $25K
71275 Computed tomographic angiography, chest, with contrast material 271 264 $25K
76820 289 182 $25K
73030 659 581 $24K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 324 310 $23K
96361 Intravenous infusion, hydration; each additional hour 1,909 1,714 $23K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 14,587 12,608 $22K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 17 15 $21K
76770 196 194 $20K
77065 Tomosynthesis, mammo 161 152 $20K
73630 684 575 $17K
73610 463 417 $16K
72141 33 33 $16K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 392 385 $15K
73502 319 312 $15K
80048 Basic metabolic panel (calcium, ionized) 3,564 2,781 $14K
77080 146 144 $14K
72040 278 272 $14K
73562 308 252 $14K
73221 30 26 $14K
73560 328 259 $14K
74176 Computed tomography, abdomen and pelvis; without contrast material 212 208 $13K
87631 382 345 $13K
76819 Fetal biophysical profile; without non-stress testing 75 53 $12K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 2,371 2,164 $12K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 513 488 $11K
73130 404 339 $11K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 75 71 $11K
93923 68 65 $11K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 28 24 $11K
01999 301 285 $10K
96375 Therapeutic injection; each additional sequential IV push 1,868 1,661 $10K
71045 Radiologic examination, chest; single view 2,880 2,637 $10K
70486 95 92 $10K
72125 Computed tomography, cervical spine; without contrast material 389 358 $9K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 882 836 $9K
T1015 Clinic visit/encounter, all-inclusive 836 770 $9K
88305 Level IV - Surgical pathology, gross and microscopic examination 228 216 $8K
73110 257 227 $7K
97598 82 54 $7K
81025 2,400 2,171 $7K
97166 115 111 $7K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 632 616 $6K
72072 93 91 $6K
J1885 Injection, ketorolac tromethamine, per 15 mg 3,545 3,216 $6K
84484 3,339 2,820 $6K
0001A 395 394 $6K
90715 158 152 $6K
J3490 Unclassified drugs 5,255 3,339 $5K
A0425 Ground mileage, per statute mile 2,863 2,436 $5K
97803 81 68 $5K
90834 Psychotherapy, 45 minutes with patient 3,507 1,447 $4K
83735 1,995 1,458 $4K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 53 43 $4K
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r 292 279 $4K
85730 1,959 1,762 $4K
92588 34 34 $4K
95886 25 25 $4K
97113 42 12 $4K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 479 468 $4K
73080 144 131 $4K
72110 49 49 $3K
85027 930 776 $3K
74246 31 30 $3K
97016 129 46 $3K
J1030 Injection, methylprednisolone acetate, 40 mg 219 210 $3K
85610 2,183 1,939 $3K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 160 152 $3K
80061 Lipid panel 275 257 $3K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 220 153 $3K
C1769 Guide wire 172 145 $3K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 480 468 $2K
90792 Psychiatric diagnostic evaluation with medical services 40 38 $2K
83690 1,868 1,743 $2K
87086 Culture, bacterial; quantitative colony count, urine 837 767 $2K
84443 Thyroid stimulating hormone (TSH) 233 216 $2K
93880 12 12 $2K
97802 35 33 $2K
83880 548 502 $2K
86900 486 454 $2K
J0696 Injection, ceftriaxone sodium, per 250 mg 998 883 $2K
81001 2,650 2,453 $2K
97014 85 30 $2K
20552 17 17 $2K
86850 430 403 $2K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 1,004 918 $2K
87481 141 139 $2K
72050 24 24 $2K
84703 539 518 $2K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 521 279 $2K
83605 616 549 $2K
95806 13 13 $2K
80320 205 180 $2K
94060 26 26 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 118 116 $1K
73590 53 50 $1K
97168 12 12 $1K
83036 Hemoglobin; glycosylated (A1C) 229 218 $1K
84100 851 574 $1K
92567 36 36 $1K
96367 16 12 $1K
J2405 Injection, ondansetron hydrochloride, per 1 mg 3,302 2,848 $1K
86901 447 420 $1K
97116 244 156 $1K
J3486 Injection, ziprasidone mesylate, 10 mg 25 15 $920.86
82550 341 281 $903.21
74018 39 37 $886.45
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,208 1,098 $822.05
97165 45 40 $814.67
72202 14 14 $786.15
81003 683 639 $760.08
J2060 Injection, lorazepam, 2 mg 675 549 $728.14
97018 43 12 $709.96
73620 22 15 $699.54
J2270 Injection, morphine sulfate, up to 10 mg 1,767 1,354 $683.12
87040 188 172 $657.16
84702 132 113 $643.23
82077 312 290 $634.29
0202U Oncology (prostate), multianalyte, gene expression profiling 54 54 $579.94
J2704 Injection, propofol, 10 mg 650 629 $520.61
87088 258 246 $471.07
76882 15 13 $458.04
80051 55 51 $453.76
A0432 Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers 15 14 $446.12
J7030 Infusion, normal saline solution , 1000 cc 5,906 5,139 $431.50
87641 96 87 $426.08
73140 16 14 $415.19
85379 207 197 $384.95
87186 192 183 $341.13
87511 121 119 $336.31
J1630 Injection, haloperidol, up to 5 mg 353 287 $314.97
J1650 Injection, enoxaparin sodium, 10 mg 1,027 524 $301.42
J2765 Injection, metoclopramide hcl, up to 10 mg 850 759 $281.23
87800 38 38 $240.28
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 13 12 $223.30
J3010 Injection, fentanyl citrate, 0.1 mg 1,204 1,092 $223.13
99152 12 12 $207.09
80329 27 27 $202.15
J1200 Injection, diphenhydramine hcl, up to 50 mg 906 789 $196.68
87077 132 129 $178.46
96376 375 274 $164.69
82565 66 62 $155.85
84520 67 63 $149.11
J1644 Injection, heparin sodium, per 1000 units 431 222 $140.86
90832 Psychotherapy, 30 minutes with patient 310 172 $136.17
82947 53 50 $98.83
J7050 Infusion, normal saline solution, 250 cc 473 351 $82.99
J0690 Injection, cefazolin sodium, 500 mg 292 234 $68.03
87205 13 12 $65.97
J2250 Injection, midazolam hydrochloride, per 1 mg 1,037 975 $52.47
86140 50 40 $35.46
85652 28 25 $29.19
36416 53 46 $12.96
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 12 12 $4.45
90853 Group psychotherapy (other than of a multiple-family group) 451 62 $3.62
J3475 Injection, magnesium sulfate, per 500 mg 238 198 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 350 324 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 98 75 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 948 755 $0.00
94664 32 30 $0.00
J1953 Injection, levetiracetam, 10 mg 85 73 $0.00
S0028 Injection, famotidine, 20 mg 612 561 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 124 120 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 91 78 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 51 46 $0.00
J3372 Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg 21 15 $0.00
80143 26 25 $0.00
J0171 Injection, adrenalin, epinephrine, 0.1 mg 28 28 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 141 129 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 456 428 $0.00
J1170 Injection, hydromorphone, up to 4 mg 69 39 $0.00
J2785 Injection, regadenoson, 0.1 mg 90 90 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 44 40 $0.00
J1790 Injection, droperidol, up to 5 mg 15 13 $0.00
A0888 Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) 136 133 $0.00
J0360 Injection, hydralazine hcl, up to 20 mg 17 12 $0.00
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 20 20 $0.00
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 16 14 $0.00