Covenant Medical Center INC
Covenant Medical Center INC was paid $22.00M by Medicaid between Jan 2018 and Dec 2024, across 156 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 29% of everything it billed.
WATERLOO, IA 50702
Next to other Counselor providers in Iowa
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 114,679 | $3.09M | |
| 2019 | 176,800 | $3.18M | |
| 2020 | 127,110 | $2.68M | |
| 2021 | 140,917 | $3.16M | |
| 2022 | 146,858 | $3.29M | |
| 2023 | 143,156 | $3.51M | |
| 2024incomplete | 111,269 | $3.10M |
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 | 29% | 247,142 | 229,621 | $6.29M |
| 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 | 20% | 126,340 | 115,502 | $4.40M |
| 90792 | Psychiatric diagnostic evaluation with medical services | 7.3% | 14,404 | 13,135 | $1.61M |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 5.4% | 15,807 | 10,098 | $1.19M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.6% | 12,803 | 12,650 | $1.00M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.5% | 14,319 | 13,226 | $994K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 3.1% | 11,420 | 7,944 | $672K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.9% | 8,272 | 8,181 | $643K |
| 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 | 2.3% | 7,451 | 7,141 | $498K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.6% | 10,041 | 4,281 | $356K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.6% | 7,051 | 6,452 | $349K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.5% | 3,967 | 3,903 | $340K |
144 more codes
| 99203 | Doctor's office visit, new patient (routine) | 1.5% | 7,547 | $332K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.4% | 12,395 | $309K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.3% | 39,447 | $294K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.3% | 5,428 | $291K |
| 20610 | <1% | 4,912 | $178K | |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | <1% | 8,325 | $176K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 2,206 | $168K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 1,284 | $156K |
| 95251 | <1% | 2,048 | $125K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,977 | $116K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 1,215 | $94K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 1,341 | $92K |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 820 | $88K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,711 | $77K |
| 90785 | <1% | 14,938 | $62K | |
| 00170 | Anesthesia for intraoral procedures, including biopsy | <1% | 357 | $60K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 534 | $52K |
| 99205 | Prolong outpt/office vis | <1% | 501 | $47K |
| 11721 | <1% | 4,074 | $44K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 849 | $40K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 877 | $40K |
| 99217 | <1% | 721 | $37K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 648 | $37K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 2,291 | $36K |
| Q3014 | Telehealth originating site facility fee | <1% | 1,777 | $32K |
| 95911 | <1% | 348 | $32K | |
| 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | <1% | 358 | $31K |
| 99218 | <1% | 521 | $28K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 276 | $26K |
| 0002A | <1% | 720 | $25K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 325 | $25K |
| 95886 | <1% | 734 | $22K | |
| 0001A | <1% | 774 | $21K | |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 335 | $21K |
| 99442 | <1% | 679 | $21K | |
| 99220 | <1% | 223 | $20K | |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | <1% | 114 | $20K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 1,064 | $19K |
| 59025 | Fetal non-stress test | <1% | 683 | $18K |
| 99223 | Prolong inpt eval add15 m | <1% | 206 | $17K |
| 95909 | <1% | 261 | $15K | |
| 93018 | <1% | 1,215 | $15K | |
| 90961 | <1% | 269 | $14K | |
| 73630 | <1% | 1,704 | $13K | |
| 99381 | <1% | 187 | $13K | |
| 93016 | <1% | 729 | $12K | |
| 99152 | <1% | 1,331 | $12K | |
| 99443 | <1% | 349 | $11K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 64 | $11K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 326 | $11K |
| 93320 | <1% | 343 | $10K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 1,144 | $10K |
| 93000 | <1% | 516 | $10K | |
| 95806 | <1% | 104 | $9K | |
| 93325 | <1% | 498 | $9K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 122 | $9K |
| 0012A | <1% | 219 | $7K | |
| 94010 | <1% | 914 | $7K | |
| 99219 | <1% | 88 | $7K | |
| 73562 | <1% | 843 | $6K | |
| 93458 | <1% | 44 | $6K | |
| 77427 | <1% | 58 | $6K | |
| 0011A | <1% | 264 | $6K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 63 | $6K |
| 95885 | <1% | 424 | $5K | |
| 99460 | <1% | 85 | $5K | |
| 99224 | <1% | 215 | $5K | |
| 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% | 688 | $4K |
| 11056 | <1% | 878 | $4K | |
| 76536 | <1% | 224 | $4K | |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 645 | $4K |
| 62323 | <1% | 70 | $4K | |
| 27096 | <1% | 27 | $4K | |
| 93227 | <1% | 130 | $3K | |
| 73564 | <1% | 305 | $3K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 225 | $3K |
| 99417 | Prolong home eval add 15m | <1% | 35 | $3K |
| 64615 | <1% | 42 | $2K | |
| 95811 | <1% | 13 | $2K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 16 | $2K |
| 11750 | <1% | 29 | $2K | |
| 31575 | <1% | 42 | $2K | |
| G6002 | Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy | <1% | 121 | $2K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 38 | $2K |
| 90970 | <1% | 631 | $2K | |
| 99441 | <1% | 86 | $2K | |
| 43249 | <1% | 19 | $2K | |
| 95912 | <1% | 12 | $1K | |
| 92504 | <1% | 213 | $1K | |
| 00126 | <1% | 17 | $1K | |
| 52000 | <1% | 27 | $1K | |
| 99307 | <1% | 66 | $1K | |
| 54150 | <1% | 12 | $1K | |
| 92567 | <1% | 110 | $1K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 192 | $925.92 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 41 | $897.34 |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 41 | $799.57 |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 77 | $797.83 |
| 99310 | Prolong nursin fac eval 15m | <1% | 142 | $742.64 |
| 11057 | <1% | 126 | $732.67 | |
| 73030 | <1% | 96 | $625.41 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 78 | $561.78 |
| 94726 | <1% | 57 | $442.89 | |
| 31231 | <1% | 13 | $409.09 | |
| 20553 | <1% | 28 | $372.62 | |
| 94729 | <1% | 58 | $291.71 | |
| 20552 | <1% | 14 | $230.86 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 48 | $216.04 |
| 94060 | <1% | 12 | $178.35 | |
| 97803 | <1% | 87 | $153.73 | |
| 99304 | <1% | 18 | $151.04 | |
| 73130 | <1% | 14 | $114.24 | |
| 73100 | <1% | 12 | $93.92 | |
| 92587 | <1% | 20 | $74.81 | |
| 3066F | <1% | 171 | $20.00 | |
| 1036F | <1% | 65,524 | $0.25 | |
| 0502F | <1% | 18,564 | $0.25 | |
| 99153 | Mod sedat endo service >5yrs | <1% | 18 | $0.12 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | <1% | 96,217 | $0.09 |
| G8783 | Normal blood pressure reading documented, follow-up not required | <1% | 72,444 | $0.07 |
| G8952 | Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given | 0% | 8,033 | $0.00 |
| 3017F | 0% | 10,969 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 20,180 | $0.00 |
| 3008F | 0% | 3,452 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 7,029 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 13,949 | $0.00 |
| 99459 | 0% | 28 | $0.00 | |
| G8708 | Patient not prescribed antibiotic | 0% | 5,476 | $0.00 |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 69 | $0.00 |
| 99406 | 0% | 24 | $0.00 | |
| 87807 | 0% | 15 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 12 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 10,277 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 200 | $0.00 |
| 3210F | 0% | 2,680 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 857 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 359 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 468 | $0.00 |
| G8399 | Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed | 0% | 333 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 70 | $0.00 |
| 4004F | 0% | 331 | $0.00 | |
| 3046F | 0% | 34 | $0.00 | |
| G8709 | Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) | 0% | 118 | $0.00 |
| G8506 | Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy | 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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Covenant Medical Center INC | Waterloo, IA | $63.08M |
| Covenant Medical Center INC | Waterloo, IA | $2.06M |
| Mercy Hospital of Franciscan Sisters INC | Oelwein, IA | $1.97M |
| Covenant Medical Center INC | Waterloo, IA | $618K |
| Sartori Memorial Hospital INC | Cedar Falls, IA | $439K |
| Sartori Memorial Hospital INC | Cedar Falls, IA | $313K |
| Covenant Medical Center INC | Arlington, IA | $225K |
| Mercy Hospital of Franciscan Sisters INC | Oelwein, IA | $139K |
| Sartori Memorial Hospital INC | Cedar Falls, IA | $117K |
| Covenant Medical Center INC | Waterloo, IA | $99K |
| Mercy Hospital of Franciscan Sisters INC | Oelwein, IA | $15K |
| Covenant Medical Center INC | Waterloo, IA | $12K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.