Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WI › SUPERIOR › ST. MARY'S HOSPITAL OF SUPERIOR

ST. MARY'S HOSPITAL OF SUPERIOR

NPI: 1588691588 · SUPERIOR, WI 54880 · Critical Access Hospital Clinic/Center · NPI assigned 06/26/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official BOREN, KEVIN controls 20+ related entities in our dataset. Read more

$1.65M
Total Medicaid Paid
54,090
Total Claims
46,026
Beneficiaries
49
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOREN, KEVIN (VP OF FINANCE)
Parent OrganizationESSENTIA HEALTH
NPI Enumeration Date06/26/2006

Related Entities

Other providers sharing the same authorized official: BOREN, KEVIN

ProviderCityStateTotal Paid
THE DULUTH CLINIC, LTD DULUTH MN $51.60M
ST. JOSEPH'S MEDICAL CENTER BRAINERD MN $41.35M
SMDC MEDICAL CENTER DULUTH MN $35.51M
ST MARYS MEDICAL CENTER DULUTH MN $20.98M
ST. MARY'S HOSPITAL OF SUPERIOR SUPERIOR WI $13.36M
ST JOSEPH'S MEDICAL CENTER BAXTER MN $7.23M
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM DULUTH MN $4.97M
DEER RIVER HEALTHCARE CENTER, INC. DEER RIVER MN $4.57M
ST. MARY'S MEDICAL CENTER DULUTH MN $3.66M
ST. JOSEPH'S MEDICAL CENTER BRAINERD MN $3.25M
THE DULUTH CLINIC, LTD VIRGINIA MN $2.82M
THE DULUTH CLINIC, LTD DULUTH MN $2.66M
NORTHERN PINES MEDICAL CENTER AURORA MN $1.72M
POLINSKY MEDICAL REHABILITATION CENTER DULUTH MN $1.61M
PINE MEDICAL CENTER SANDSTONE MN $1.32M
THE DULUTH CLINIC, LTD HERMANTOWN MN $1.30M
THE DULUTH CLINIC LTD GRAND RAPIDS MN $1.18M
THE DULUTH CLINIC, LTD DULUTH MN $1.13M
THE DULUTH CLINIC, LTD ASHLAND WI $1.07M
ST MARY'S HOSPITAL OF SUPERIOR SPOONER WI $1.05M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 5,079 $122K
2019 5,330 $146K
2020 5,105 $127K
2021 8,585 $213K
2022 10,154 $294K
2023 11,193 $333K
2024 8,644 $418K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 21,019 17,840 $973K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 13,695 12,321 $436K
90834 Psychotherapy, 45 minutes with patient 1,982 1,088 $73K
99283 Emergency department visit for the evaluation and management, moderate severity 1,333 1,266 $31K
99309 Subsequent nursing facility care, per day, low to moderate complexity 1,820 1,518 $26K
99215 Prolong outpt/office vis 279 229 $17K
90686 1,268 1,096 $14K
99605 210 205 $11K
99310 Prolong nursin fac eval 15m 453 396 $10K
99284 Emergency department visit for the evaluation and management, high severity 244 234 $8K
99308 Subsequent nursing facility care, per day, straightforward 394 258 $6K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 246 221 $5K
96130 48 37 $4K
99607 37 37 $3K
92015 Determination of refractive state 448 398 $3K
0002A 93 90 $3K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 99 87 $3K
0012A 110 95 $3K
0001A 85 82 $3K
0072A 100 68 $3K
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 58 55 $2K
36415 Collection of venous blood by venipuncture 8,174 6,814 $2K
0011A 90 81 $2K
0071A 86 54 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 27 26 $2K
20610 21 13 $1K
90791 Psychiatric diagnostic evaluation 14 13 $1K
Q3014 Telehealth originating site facility fee 94 70 $1K
99282 Emergency department visit for the evaluation and management, low to moderate severity 51 50 $1K
90656 28 24 $596.31
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 13 13 $532.34
0064A 20 13 $498.36
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 13 12 $488.61
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 14 14 $471.87
99356 13 12 $380.10
99443 21 12 $352.20
92551 30 27 $298.92
99307 67 55 $280.35
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 68 53 $279.24
96127 62 51 $215.65
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 13 13 $146.88
99305 15 14 $73.78
99497 12 12 $69.84
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 25 25 $0.00
91301 257 224 $0.00
91307 165 109 $0.00
0352U 15 14 $0.00
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) 424 373 $0.00
91300 237 214 $0.00