Hospital
ST Marys Healthcare
ST Marys Healthcare was paid $1.85M by Medicaid between Jan 2018 and Nov 2024, across 36 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 70% of everything it billed.
33Billing provider infoST MARYS HEALTHCARE
AMSTERDAM, NY 12010
AMSTERDAM, NY 12010
33aNPI1518926401assigned 03/21/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$1.85M
24GClaims37,581
24DCodes billed36
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in New York
Rank by total paid#109 of 231
Median peer was paid$561K
This provider vs. median3.3×
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 | 2,424 | $94K | |
| 2019 | 3,537 | $157K | |
| 2020 | 4,143 | $181K | |
| 2021 | 6,290 | $310K | |
| 2022 | 6,270 | $285K | |
| 2023 | 8,794 | $488K | |
| 2024incomplete | 6,123 | $330K |
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 | 70% | 25,276 | 24,609 | $1.29M |
| 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 | 13% | 3,981 | 3,854 | $242K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.0% | 2,615 | 2,599 | $92K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.8% | 956 | 949 | $52K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.8% | 581 | 579 | $33K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.7% | 631 | 569 | $32K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.2% | 330 | 328 | $23K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.1% | 177 | 175 | $20K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 201 | 200 | $14K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 391 | 388 | $13K |
| 00170 | Anesthesia for intraoral procedures, including biopsy | <1% | 39 | 39 | $8K |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 276 | 276 | $3K |
24 more codes
| 90461 | <1% | 38 | $3K | |
| 99406 | <1% | 660 | $2K | |
| 80053 | Comprehensive metabolic panel | <1% | 132 | $2K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 29 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 37 | $2K |
| 00731 | <1% | 12 | $2K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 156 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 30 | $2K |
| 59025 | Fetal non-stress test | <1% | 37 | $1K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 72 | $742.55 |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 24 | $630.94 |
| 99459 | <1% | 31 | $594.78 | |
| 64615 | <1% | 13 | $566.23 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 25 | $459.38 |
| 99221 | <1% | 12 | $431.60 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 13 | $407.03 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 12 | $100.00 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 38 | $96.62 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 37 | $50.00 |
| 96160 | <1% | 127 | $22.66 | |
| 94760 | <1% | 176 | $1.54 | |
| M1069 | Patient screened for future fall risk | 0% | 273 | $0.00 |
| 90686 | 0% | 56 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 87 | $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 officialLOPEZ, HEATHER (DIRECTOR PRIMARY & SPECIALTY CARE)