Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Hospital

San Gorgonio Memorial Hospital

San Gorgonio Memorial Hospital was paid $25.30M by Medicaid between Jan 2018 and Nov 2024, across 221 billing codes. Its largest line is 0450, Emergency room services — 15% of everything it billed.

33Billing provider infoSAN GORGONIO MEMORIAL HOSPITAL
BANNING, CA 92220
33aNPI1568469997assigned 06/30/2005
33bProvider typeGeneral Acute Care Hospital
28Total paid$25.30M
24GClaims819,956
24DCodes billed221
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers

Next to other General Acute Care Hospital providers in California

Rank by total paid#105 of 410
Median peer was paid$6.90M
This provider vs. median3.7×

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

$0$200K$400K$600K2018201920202021202220232024
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
YearClaimsPaid
2018116,774$2.86M
2019132,161$3.30M
202091,312$2.32M
2021100,853$3.12M
2022123,299$4.45M
2023132,316$4.76M
2024incomplete123,241$4.48M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
0450 Emergency room services 15% 74,219 64,103 $3.76M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 11% 45,239 40,220 $2.84M
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 7.0% 4,803 4,695 $1.77M
74177 Computed tomography, abdomen and pelvis; with contrast material 5.9% 6,952 6,723 $1.49M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 5.2% 19,887 18,409 $1.31M
70450 Computed tomography, head or brain; without contrast material 5.1% 8,026 7,738 $1.29M
80053 Comprehensive metabolic panel 2.9% 39,271 34,596 $731K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 2.9% 23,062 21,123 $723K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 2.3% 44,568 38,450 $590K
93976 2.3% 2,890 2,781 $573K
96375 Therapeutic injection; each additional sequential IV push 2.0% 13,400 12,397 $503K
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 1.9% 6,652 6,014 $477K
209 more codes
74176 Computed tomography, abdomen and pelvis; without contrast material 1.7% 4,157 $434K
72125 Computed tomography, cervical spine; without contrast material 1.7% 1,979 $428K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1.6% 5,296 $415K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1.5% 13,668 $372K
Z7502 1.3% 8,998 $333K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1.0% 4,907 $265K
99285 Emergency room visit (most serious) 1.0% 1,719 $257K
99070 <1% 48,749 $246K
84484 <1% 13,358 $239K
71045 Radiologic examination, chest; single view <1% 19,652 $233K
82553 <1% 12,444 $212K
96361 Intravenous infusion, hydration; each additional hour <1% 6,860 $212K
71275 Computed tomographic angiography, chest, with contrast material <1% 1,196 $210K
83690 <1% 16,089 $187K
99499 <1% 3,001 $173K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 2,953 $169K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 2,384 $158K
99284 Emergency room visit (serious) <1% 1,747 $156K
71046 Radiologic examination, chest; 2 views <1% 6,764 $154K
0762 <1% 2,551 $149K
81001 <1% 24,135 $145K
77067 Screening mammography, bilateral, including computer-aided detection <1% 1,472 $140K
87088 <1% 16,146 $133K
90853 Group psychotherapy (other than of a multiple-family group) <1% 10,217 $131K
83880 <1% 4,961 $124K
87076 <1% 4,365 $124K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 1,866 $120K
J3490 Unclassified drugs <1% 25,694 $116K
93971 <1% 857 $109K
G0378 Hospital observation service, per hour <1% 1,828 $107K
81025 <1% 13,089 $104K
85730 <1% 11,708 $104K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 2,105 $102K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 4,211 $100K
82550 <1% 9,642 $91K
83605 <1% 4,566 $82K
84703 <1% 6,080 $80K
87040 <1% 4,628 $79K
87186 <1% 4,848 $79K
85610 <1% 12,063 $70K
84443 Thyroid stimulating hormone (TSH) <1% 2,370 $66K
90715 <1% 1,931 $65K
76801 <1% 1,042 $63K
72100 <1% 2,038 $60K
73030 <1% 2,219 $59K
70486 <1% 321 $58K
73562 <1% 2,417 $56K
73610 <1% 2,042 $54K
87430 <1% 2,943 $53K
73130 <1% 1,967 $52K
84702 <1% 2,637 $50K
73630 <1% 2,012 $49K
84145 <1% 2,436 $48K
72131 <1% 257 $46K
0710 <1% 1,122 $42K
82962 <1% 6,521 $40K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 774 $39K
73110 <1% 1,376 $37K
83735 <1% 3,654 $37K
J2274 Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg <1% 2,967 $36K
80305 <1% 2,961 $34K
Z7610 <1% 2,357 $34K
82803 <1% 974 $33K
85379 <1% 2,008 $33K
59025 Fetal non-stress test <1% 1,222 $32K
80047 <1% 4,136 $31K
87335 <1% 2,272 $30K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 383 $30K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 16,419 $29K
81002 <1% 6,493 $27K
84481 <1% 1,151 $27K
84439 <1% 1,657 $26K
87070 <1% 1,933 $25K
74018 <1% 1,135 $22K
70496 <1% 118 $21K
93970 <1% 95 $19K
0370 <1% 121 $19K
86901 <1% 2,391 $16K
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 7,463 $16K
84100 <1% 2,678 $16K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 426 $16K
J0131 Injection, acetaminophen, not otherwise specified,10 mg <1% 745 $16K
72040 <1% 568 $14K
70498 <1% 131 $14K
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 5,570 $14K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 11,775 $14K
73080 <1% 496 $13K
83036 Hemoglobin; glycosylated (A1C) <1% 827 $13K
99221 <1% 67 $13K
73590 <1% 618 $13K
73090 <1% 599 $12K
96367 <1% 281 $12K
0270 <1% 451 $12K
86900 <1% 2,012 $11K
87086 Culture, bacterial; quantitative colony count, urine <1% 1,347 $11K
71250 <1% 50 $11K
99238 Hospital discharge day management, 30 minutes or less <1% 301 $10K
12001 <1% 601 $10K
J2270 Injection, morphine sulfate, up to 10 mg <1% 2,832 $10K
82010 <1% 705 $10K
86140 <1% 1,274 $10K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,961 $10K
72070 <1% 332 $10K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 217 $10K
36415 Collection of venous blood by venipuncture <1% 4,871 $10K
73620 <1% 519 $10K
82140 <1% 480 $9K
86850 <1% 712 $9K
71101 <1% 193 $8K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 62 $8K
P9016 Red blood cells, leukocytes reduced, each unit <1% 25 $8K
87652 <1% 485 $7K
87210 <1% 862 $7K
73502 <1% 250 $7K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 1,053 $7K
85651 <1% 1,274 $6K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 7,548 $6K
76770 <1% 92 $6K
87400 <1% 1,102 $6K
87075 <1% 313 $6K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 384 $6K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 335 $6K
73560 <1% 295 $6K
S0164 Injection, pantoprazole sodium, 40 mg <1% 816 $6K
73600 <1% 273 $6K
76870 <1% 91 $6K
73120 <1% 298 $5K
73140 <1% 320 $5K
0259 <1% 2,107 $5K
86904 <1% 672 $5K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) <1% 108 $5K
J7120 Ringers lactate infusion, up to 1000 cc <1% 1,015 $5K
80061 Lipid panel <1% 250 $4K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 172 $4K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) <1% 1,874 $4K
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 2,523 $4K
82728 <1% 192 $3K
81015 <1% 851 $3K
J1170 Injection, hydromorphone, up to 4 mg <1% 803 $3K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 254 $3K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 39 $3K
J2060 Injection, lorazepam, 2 mg <1% 2,161 $3K
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 2,067 $3K
70491 <1% 13 $3K
99219 <1% 26 $3K
J3010 Injection, fentanyl citrate, 0.1 mg <1% 2,170 $2K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg <1% 1,705 $2K
C9113 Injection, pantoprazole sodium, per vial <1% 342 $2K
87420 <1% 124 $2K
96376 <1% 144 $2K
99217 <1% 65 $2K
10060 <1% 107 $2K
72128 <1% 12 $2K
29125 <1% 215 $2K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 112 $2K
83615 <1% 201 $2K
J1940 Injection, furosemide, up to 20 mg <1% 547 $1K
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) <1% 311 $1K
82947 <1% 284 $1K
96368 <1% 56 $1K
74022 <1% 31 $1K
87449 <1% 116 $1K
Z9725 <1% 33 $1K
J0690 Injection, cefazolin sodium, 500 mg <1% 565 $1K
J3370 Injection, vancomycin hcl, 500 mg <1% 169 $1K
76641 <1% 14 $1K
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 1,725 $1K
12011 <1% 55 $1K
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen <1% 1,568 $987.24
12002 <1% 12 $963.09
J1650 Injection, enoxaparin sodium, 10 mg <1% 482 $921.07
J0780 Injection, prochlorperazine, up to 10 mg <1% 260 $916.62
J3475 Injection, magnesium sulfate, per 500 mg <1% 167 $826.47
J1644 Injection, heparin sodium, per 1000 units <1% 300 $792.63
94760 <1% 153 $742.71
72170 <1% 46 $710.06
97116 <1% 68 $686.87
71020 <1% 28 $674.19
J1815 Injection, insulin, per 5 units <1% 80 $656.00
J2470 Injection, pantoprazole sodium, 40 mg <1% 112 $522.35
29515 <1% 71 $478.97
J0735 Injection, clonidine hydrochloride, 1 mg <1% 28 $463.34
73100 <1% 26 $463.32
84597 <1% 20 $436.80
82247 <1% 62 $434.11
J2175 Injection, meperidine hydrochloride, per 100 mg <1% 105 $425.99
Q0144 Azithromycin dihydrate, oral, capsules/powder, 1 gram <1% 63 $399.77
0258 <1% 229 $340.35
J2550 Injection, promethazine hcl, up to 50 mg <1% 113 $302.31
Q0163 Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen <1% 837 $280.00
73060 <1% 14 $254.73
73070 <1% 13 $241.68
S0077 Injection, clindamycin phosphate, 300 mg <1% 21 $225.47
85007 <1% 69 $205.21
87185 <1% 107 $162.21
87592 <1% 13 $153.60
J0456 Injection, azithromycin, 500 mg <1% 72 $133.10
J3480 Injection, potassium chloride, per 2 meq <1% 46 $122.52
87147 <1% 26 $120.45
J1630 Injection, haloperidol, up to 5 mg <1% 53 $84.88
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 167 $76.25
J2300 Injection, nalbuphine hydrochloride, per 10 mg <1% 21 $58.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 75 $44.90
90834 Psychotherapy session, about 45 minutes <1% 253 $30.45
J8540 Dexamethasone, oral, 0.25 mg <1% 26 $25.30
J1171 Injection, hydromorphone, 0.1 mg <1% 18 $1.53
90832 Psychotherapy session, about 30 minutes 0% 85 $0.00
Q4051 Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) 0% 27 $0.00
0250 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 officialBROWN, MAYDA (DIRECTOR PT. FIN. SVC.)