The Shriners' Hospital for Children

The Shriners' Hospital for Children was paid $5.42M by Medicaid between Jan 2018 and Jul 2023, across 33 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 40% of everything it billed.

33Billing provider infoTHE SHRINERS' HOSPITAL FOR CHILDREN
SPRINGFIELD, MA 01104

33aNPI1528195724assigned 02/27/2007

33bProvider typeChildren's Hospital

28Total paid$5.42M

24GClaims36,395

24DCodes billed33

24AFirst – last monthJan 2018 – Jul 2023

Compared with peers

Next to other Children's Hospital providers in Massachusetts

Rank by total paid#1 of 6

Median peer was paid$26K

This provider vs. median210×

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	8,288	$1.18M
2019	8,153	$1.19M
2020	4,325	$777K
2021	7,643	$1.10M
2022	7,750	$1.16M
2023	236	$15K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	40%	12,284	11,744	$2.15M
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	16%	6,095	3,025	$890K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	14%	4,130	3,995	$770K
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	8.8%	2,045	2,034	$478K
97530	Therapeutic activities, direct patient contact, each 15 minutes	4.6%	2,265	1,164	$252K
97161		4.2%	1,919	1,872	$226K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	3.6%	1,564	1,498	$196K
J3490	Unclassified drugs	2.6%	437	209	$141K
72082		1.2%	1,638	1,622	$66K
97116		1.1%	494	254	$61K
99205	Prolong outpt/office vis	<1%	232	224	$35K
92507	Treatment of speech, language, voice, communication, and/or auditory processing disorder	<1%	144	76	$33K

21 more codes

29450		<1%	90	$27K
72081		<1%	286	$20K
72170		<1%	326	$16K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	85	$11K
J7120	Ringers lactate infusion, up to 1000 cc	<1%	217	$7K
25600		<1%	13	$5K
97165		<1%	66	$5K
97162		<1%	28	$5K
97542		<1%	14	$4K
77073		<1%	321	$2K
97535	Self-care/home management training, each 15 minutes	<1%	25	$2K
J2405	Injection, ondansetron hydrochloride, per 1 mg	<1%	406	$2K
J0131	Injection, acetaminophen, not otherwise specified,10 mg	<1%	217	$2K
73521		<1%	252	$1K
J3010	Injection, fentanyl citrate, 0.1 mg	<1%	204	$1K
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	149	$880.61
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	17	$761.82
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	183	$518.60
J2704	Injection, propofol, 10 mg	<1%	207	$363.15
J0690	Injection, cefazolin sodium, 500 mg	<1%	27	$306.26
73620		<1%	15	$204.48

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 officialKIRK, LEE (ADMINISTRATOR)