Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SAMUEL MAHELONA MEMORIAL HOSPITAL

NPI: 1619038536 · KAPAA, HI 96746 · Critical Access Hospital · NPI assigned 12/13/2006

$7.01M
Total Medicaid Paid
38,585
Total Claims
32,780
Beneficiaries
43
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLORENZO, RACHELLE (CFO)
NPI Enumeration Date12/13/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 5,163 $924K
2019 5,375 $908K
2020 3,396 $727K
2021 4,213 $781K
2022 6,635 $1.10M
2023 7,354 $1.28M
2024 6,449 $1.29M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99283 Emergency department visit for the evaluation and management, moderate severity 8,781 7,867 $3.46M
99282 Emergency department visit for the evaluation and management, low to moderate severity 5,773 5,228 $1.59M
99284 Emergency department visit for the evaluation and management, high severity 2,148 1,941 $1.33M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 503 428 $504K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1,629 536 $69K
74177 Computed tomography, abdomen and pelvis; with contrast material 12 12 $25K
97032 311 125 $22K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 661 244 $12K
87428 1,318 1,200 $3K
96361 Intravenous infusion, hydration; each additional hour 486 437 $1K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 487 461 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,521 2,218 $702.90
81025 671 607 $661.97
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 788 707 $331.91
81002 1,438 1,341 $305.86
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 1,123 940 $297.07
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 147 102 $143.01
80305 12 12 $110.08
96375 Therapeutic injection; each additional sequential IV push 375 323 $106.62
80047 1,610 1,414 $83.51
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 44 41 $81.98
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 191 184 $74.82
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 1,342 934 $50.41
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,447 1,290 $28.39
J1885 Injection, ketorolac tromethamine, per 15 mg 1,372 1,212 $27.05
J2405 Injection, ondansetron hydrochloride, per 1 mg 126 119 $22.28
85025 Blood count; complete (CBC), automated, and automated differential WBC count 14 13 $20.00
85014 1,606 1,414 $17.62
J7030 Infusion, normal saline solution , 1000 cc 216 200 $13.24
C1751 Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) 624 547 $1.95
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 28 25 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 65 63 $0.00
A9270 Non-covered item or service 33 29 $0.00
71045 Radiologic examination, chest; single view 179 153 $0.00
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 118 104 $0.00
97035 63 24 $0.00
82803 30 24 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 13 13 $0.00
84484 89 75 $0.00
83605 30 24 $0.00
J2270 Injection, morphine sulfate, up to 10 mg 41 39 $0.00
71046 Radiologic examination, chest; 2 views 103 93 $0.00
90715 17 17 $0.00