Hospital
Waupun Memorial Hospital
Waupun Memorial Hospital was paid $6.87M by Medicaid between Jan 2018 and Dec 2024, across 108 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 18% of everything it billed.
33Billing provider infoWAUPUN MEMORIAL HOSPITAL
WAUPUN, WI 53963
WAUPUN, WI 53963
33aNPI1548248644assigned 01/09/2006
33bProvider typeCritical Access Hospital
28Total paid$6.87M
24GClaims141,822
24DCodes billed108
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Critical Access Hospital providers in Wisconsin
Rank by total paid#20 of 48
Median peer was paid$4.30M
This provider vs. median1.6×
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 | 15,015 | $640K | |
| 2019 | 17,635 | $735K | |
| 2020 | 15,686 | $636K | |
| 2021 | 20,582 | $813K | |
| 2022 | 24,123 | $1.44M | |
| 2023 | 27,419 | $1.51M | |
| 2024incomplete | 21,362 | $1.09M |
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 | 18% | 8,410 | 6,599 | $1.24M |
| 96361 | Intravenous infusion, hydration; each additional hour | 14% | 2,583 | 1,842 | $963K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 10% | 10,798 | 5,060 | $720K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 10% | 3,978 | 3,142 | $710K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 8.6% | 4,370 | 3,129 | $593K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.0% | 4,827 | 4,118 | $482K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 6.0% | 2,927 | 2,578 | $411K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 3.2% | 817 | 708 | $219K |
| 70450 | Computed tomography, head or brain; without contrast material | 2.9% | 883 | 728 | $197K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 2.5% | 1,604 | 1,099 | $172K |
| 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 | 1.8% | 1,425 | 1,245 | $121K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 1.7% | 3,497 | 1,178 | $118K |
96 more codes
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 1.6% | 987 | $110K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 1.4% | 636 | $96K |
| 80053 | Comprehensive metabolic panel | <1% | 6,919 | $52K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 278 | $52K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 270 | $47K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 2,403 | $45K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,791 | $43K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 1,232 | $37K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 7,452 | $34K |
| 90837 | Psychotherapy session, about an hour | <1% | 383 | $33K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,009 | $30K |
| 85610 | <1% | 4,179 | $28K | |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | <1% | 364 | $25K |
| G0378 | Hospital observation service, per hour | <1% | 298 | $25K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 233 | $22K |
| 84484 | <1% | 2,611 | $18K | |
| Q3014 | Telehealth originating site facility fee | <1% | 2,294 | $16K |
| H0022 | Alcohol and/or drug intervention service (planned facilitation) | <1% | 337 | $13K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 180 | $13K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 3,733 | $12K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 175 | $10K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 109 | $10K |
| 83880 | <1% | 516 | $9K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 77 | $9K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 24 | $9K |
| 87081 | <1% | 1,390 | $8K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,787 | $8K |
| 97162 | <1% | 261 | $8K | |
| 81001 | <1% | 2,907 | $7K | |
| 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 | <1% | 165 | $6K |
| 83605 | <1% | 1,038 | $6K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 222 | $6K |
| 73630 | <1% | 219 | $5K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 66 | $5K |
| 83690 | <1% | 1,174 | $5K | |
| 86140 | <1% | 1,634 | $5K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 658 | $4K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 3,178 | $4K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,087 | $4K |
| 73564 | <1% | 133 | $4K | |
| 84703 | <1% | 543 | $3K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 28 | $3K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 35 | $3K |
| 36415 | Collection of venous blood by venipuncture | <1% | 8,395 | $3K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 16 | $3K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 30 | $2K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 262 | $2K |
| 80306 | <1% | 193 | $2K | |
| 82077 | <1% | 321 | $2K | |
| 85730 | <1% | 567 | $2K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 14 | $2K |
| 83735 | <1% | 567 | $2K | |
| 87631 | <1% | 16 | $2K | |
| 73030 | <1% | 55 | $2K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 424 | $2K |
| 76801 | <1% | 14 | $2K | |
| 82550 | <1% | 346 | $1K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 40 | $1K |
| 81025 | <1% | 154 | $1K | |
| 73610 | <1% | 36 | $1K | |
| 87077 | <1% | 207 | $1K | |
| 81003 | <1% | 799 | $1K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 71 | $754.03 |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,580 | $650.65 |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 38 | $505.10 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 4,186 | $487.99 |
| 87040 | <1% | 56 | $387.68 | |
| 85379 | <1% | 75 | $337.17 | |
| 96376 | <1% | 226 | $205.81 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 3,427 | $178.31 |
| 82150 | <1% | 28 | $172.83 | |
| 87186 | <1% | 31 | $168.91 | |
| 80143 | <1% | 15 | $166.26 | |
| 85027 | <1% | 35 | $134.49 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,011 | $123.19 |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 3,466 | $95.22 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,910 | $27.51 |
| J2704 | Injection, propofol, 10 mg | <1% | 989 | $25.34 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 813 | $7.29 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 90 | $3.95 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 1,336 | $2.38 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | <1% | 108 | $2.38 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 645 | $1.06 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 0% | 766 | $0.00 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 0% | 133 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 28 | $0.00 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 0% | 55 | $0.00 |
| J3490 | Unclassified drugs | 0% | 192 | $0.00 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 0% | 681 | $0.00 |
| J1170 | Injection, hydromorphone, up to 4 mg | 0% | 78 | $0.00 |
| A9270 | Non-covered item or service | 0% | 43 | $0.00 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 16 | $0.00 |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 0% | 17 | $0.00 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 0% | 21 | $0.00 |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 50 | $0.00 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 16 | $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 officialSCHMITZ, BONNIE (CFO)
| Provider | Location | Paid |
|---|---|---|
| Agnesian Healthcare Enterprises LLC | Fond Du Lac, WI | $2.20M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.