Great River Physicians and Clinics, INC
Great River Physicians and Clinics, INC was paid $4.55M by Medicaid between Jan 2018 and Jun 2021, across 95 billing codes. Its largest line is 99284, emergency room visit (serious) — 17% of everything it billed.
33Billing provider infoGREAT RIVER PHYSICIANS AND CLINICS, INC
WEST BURLINGTON, IA 52655
WEST BURLINGTON, IA 52655
33aNPI1518912484assigned 05/22/2006
33bProvider typeSpecialist
28Total paid$4.55M
24GClaims114,185
24DCodes billed95
24AFirst – last monthJan 2018 – Jun 2021
Compared with peers
Next to other Specialist providers in Iowa
Rank by total paid#1 of 26
Median peer was paid$58K
This provider vs. median78×
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 | 38,108 | $1.46M | |
| 2019 | 30,800 | $1.23M | |
| 2020 | 27,995 | $1.14M | |
| 2021 | 17,282 | $717K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 17% | 11,104 | 10,466 | $784K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 17% | 7,647 | 7,146 | $783K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 17% | 15,708 | 15,225 | $779K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 23,909 | 22,136 | $696K |
| 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 | 11% | 15,162 | 13,845 | $502K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 3.3% | 2,516 | 2,371 | $150K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.9% | 1,630 | 530 | $85K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.8% | 11,009 | 9,406 | $83K |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 1.3% | 1,189 | 1,149 | $61K |
| 76830 | Ultrasound, transvaginal | 1.3% | 809 | 783 | $61K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.3% | 2,156 | 762 | $57K |
| 99223 | Prolong inpt eval add15 m | 1.1% | 537 | 502 | $51K |
83 more codes
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.1% | 1,977 | $48K |
| 99203 | Doctor's office visit, new patient (routine) | 1.0% | 754 | $47K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 507 | $30K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 317 | $26K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 310 | $25K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 797 | $23K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 480 | $21K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 530 | $21K |
| 20610 | <1% | 337 | $19K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 287 | $19K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,413 | $17K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 115 | $11K |
| 96127 | <1% | 713 | $10K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 493 | $10K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 474 | $9K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 69 | $7K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 161 | $7K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 127 | $7K |
| 11721 | <1% | 682 | $7K | |
| 59025 | Fetal non-stress test | <1% | 217 | $6K |
| 88312 | <1% | 211 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 296 | $4K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 74 | $4K |
| 94060 | <1% | 317 | $4K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 40 | $4K |
| 73562 | <1% | 158 | $4K | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 375 | $3K |
| 92134 | <1% | 172 | $3K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 55 | $3K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 41 | $3K |
| 88304 | <1% | 232 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 102 | $3K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 352 | $3K |
| 90686 | <1% | 127 | $2K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 29 | $2K |
| 90837 | Psychotherapy session, about an hour | <1% | 52 | $2K |
| 88307 | <1% | 24 | $2K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 57 | $2K |
| 94726 | <1% | 167 | $2K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 32 | $1K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 107 | $1K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 26 | $1K |
| 94729 | <1% | 242 | $1K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 43 | $1K |
| 93016 | <1% | 72 | $1K | |
| 90836 | <1% | 29 | $1K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 24 | $1K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 42 | $1K |
| 99407 | <1% | 58 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 230 | $1K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 36 | $1K |
| 90961 | <1% | 15 | $949.91 | |
| 90682 | <1% | 30 | $938.81 | |
| 93018 | <1% | 72 | $905.99 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 12 | $893.58 |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 51 | $824.71 |
| 99442 | <1% | 49 | $823.13 | |
| 99441 | <1% | 48 | $682.64 | |
| 73630 | <1% | 29 | $665.22 | |
| 12001 | <1% | 14 | $645.24 | |
| 81002 | <1% | 243 | $550.68 | |
| 93990 | <1% | 13 | $514.20 | |
| 99152 | <1% | 57 | $477.13 | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 13 | $423.90 |
| 80053 | Comprehensive metabolic panel | <1% | 44 | $405.54 |
| 73610 | <1% | 17 | $396.20 | |
| 73110 | <1% | 17 | $342.68 | |
| 80061 | Lipid panel | <1% | 26 | $342.54 |
| 11720 | <1% | 85 | $321.50 | |
| 51798 | <1% | 25 | $309.09 | |
| 87210 | <1% | 26 | $284.82 | |
| 51701 | <1% | 12 | $283.19 | |
| 11719 | <1% | 28 | $200.65 | |
| 92015 | Determination of refractive state | <1% | 13 | $165.55 |
| 81025 | <1% | 16 | $139.51 | |
| 96160 | <1% | 16 | $123.81 | |
| 90785 | <1% | 98 | $96.01 | |
| 99406 | <1% | 84 | $89.10 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 13 | $66.18 |
| 81001 | <1% | 14 | $54.90 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 12 | $37.94 |
| G0008 | Administration of influenza virus vaccine | 0% | 21 | $0.00 |
| 90662 | 0% | 14 | $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 officialHAYES, TONY (VP)
| Provider | Location | Paid |
|---|---|---|
| Great River Physicians and Clinics INC | Wapello, IA | $422K |
| Great River Physicians and Clinics INC | Mediapolis, IA | $237K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.