Medicaid Provider Spending

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

MERCY HEALTH - DEFIANCE HOSPITAL LLC

NPI: 1629011234 · DEFIANCE, OH 43512 · General Acute Care Hospital · NPI assigned 06/13/2006

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

Authorized official RALSTON, KIMBERLY controls 20+ related entities in our dataset. Read more

$11.90M
Total Medicaid Paid
233,972
Total Claims
181,576
Beneficiaries
203
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRALSTON, KIMBERLY (VP REIMBURSEMENT)
NPI Enumeration Date06/13/2006

Related Entities

Other providers sharing the same authorized official: RALSTON, KIMBERLY

ProviderCityStateTotal Paid
BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC RICHMOND VA $83.03M
MARYVIEW HOSPITAL LLC PORTSMOUTH VA $75.03M
BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC RICHMOND VA $57.21M
BON SECOURS ST FRANCIS MEDICAL CENTER LLC MIDLOTHIAN VA $44.86M
MERCY HEALTH YOUNGSTOWN LLC WARREN OH $43.63M
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC MECHANICSVILLE VA $42.02M
MERCY HEALTH YOUNGSTOWN LLC YOUNGSTOWN OH $36.60M
MERCY HEALTH - FAIRFIELD HOSPITAL LLC FAIRFIELD OH $25.17M
MARY IMMACULATE HOSPITAL LLC NEWPORT NEWS VA $24.51M
ST FRANCIS HOSPITAL INC GREENVILLE SC $17.81M
NWO INTEGRATED LABORATORIES MERCY LLC TOLEDO OH $13.47M
HOSPICE OF THE VALLEY, INC. GIRARD OH $13.33M
MERCY HEALTH - TIFFIN HOSPITAL LLC TIFFIN OH $12.99M
BON SECOURS DEPAUL MEDICAL CENTER LLC NORFOLK VA $11.59M
COMMUNITY MERCY HEALTH PARTNERS URBANA OH $8.81M
MERCY HEALTH-ALLEN HOSPITAL LLC OBERLIN OH $8.61M
CHESAPEAKE HOSPITAL LLC KILMARNOCK VA $6.00M
MARYVIEW HOSPITAL, LLC SUFFOLK VA $3.48M
ROPER ST FRANCIS ANCILLARY SERVICES LADSON SC $3.33M
MERCY HEALTH YOUNGSTOWN LLC YOUNGSTOWN OH $3.23M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 6,606 $235K
2019 6,303 $231K
2020 21,276 $1.65M
2021 31,436 $2.24M
2022 24,631 $1.65M
2023 85,747 $3.47M
2024 57,973 $2.43M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G0463 Hospital outpatient clinic visit for assessment and management of a patient 65,052 52,614 $6.01M
99283 Emergency department visit for the evaluation and management, moderate severity 5,779 5,209 $640K
99284 Emergency department visit for the evaluation and management, high severity 5,312 4,318 $624K
95813 984 904 $548K
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 2,623 2,490 $445K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 2,692 2,098 $335K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 4,416 1,449 $330K
96361 Intravenous infusion, hydration; each additional hour 764 446 $229K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 2,704 669 $190K
70450 Computed tomography, head or brain; without contrast material 835 651 $181K
74177 Computed tomography, abdomen and pelvis; with contrast material 724 543 $178K
74176 Computed tomography, abdomen and pelvis; without contrast material 617 469 $150K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 834 485 $139K
97530 Therapeutic activities, direct patient contact, each 15 minutes 1,351 448 $111K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 911 894 $102K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 862 800 $97K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 573 500 $67K
20610 447 325 $66K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 348 289 $66K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 524 390 $59K
99282 Emergency department visit for the evaluation and management, low to moderate severity 536 479 $55K
80053 Comprehensive metabolic panel 6,932 5,405 $51K
90837 Psychotherapy, 53 minutes with patient 358 256 $48K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 402 343 $47K
71260 Computed tomography, thorax, diagnostic; with contrast material 247 204 $38K
80061 Lipid panel 2,076 1,808 $37K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 316 281 $35K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 185 166 $34K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1,761 1,441 $32K
36415 Collection of venous blood by venipuncture 17,463 14,021 $32K
84443 Thyroid stimulating hormone (TSH) 2,581 2,114 $31K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 428 357 $28K
80048 Basic metabolic panel (calcium, ionized) 3,589 2,776 $27K
83036 Hemoglobin; glycosylated (A1C) 2,687 2,338 $27K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 10,459 8,146 $27K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,846 1,582 $27K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,334 1,168 $26K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 219 202 $26K
93886 121 112 $23K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,076 905 $22K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 223 188 $22K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 204 200 $22K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 270 65 $21K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1,755 1,441 $20K
G0008 Administration of influenza virus vaccine 975 914 $18K
97161 289 237 $17K
71046 Radiologic examination, chest; 2 views 1,256 1,054 $17K
87428 1,497 1,268 $17K
84439 849 715 $16K
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r 99 96 $16K
95912 69 47 $16K
77067 Screening mammography, bilateral, including computer-aided detection 327 287 $16K
95957 490 477 $16K
95886 182 144 $16K
11721 626 586 $16K
82607 980 863 $14K
87086 Culture, bacterial; quantitative colony count, urine 1,612 1,316 $13K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,137 1,384 $11K
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 1,610 1,532 $11K
11720 412 371 $11K
92250 199 190 $10K
93880 178 154 $10K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 83 70 $9K
84702 556 397 $9K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,583 1,328 $9K
90686 726 682 $9K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 4,189 3,066 $9K
73630 569 452 $8K
76830 Ultrasound, transvaginal 206 171 $8K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 81 79 $8K
93017 90 57 $8K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 19 13 $8K
73562 387 318 $7K
90670 648 638 $7K
82746 833 732 $7K
72100 276 206 $7K
85027 1,561 1,222 $7K
81001 3,977 3,223 $6K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 17 14 $6K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 587 505 $5K
64483 16 14 $5K
90648 653 642 $5K
87480 629 452 $5K
92083 63 58 $4K
90472 Immunization administration, each additional vaccine (list separately) 476 468 $4K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 45 39 $4K
77063 Screening digital breast tomosynthesis, bilateral 327 287 $4K
82728 322 269 $4K
82570 520 446 $4K
G0009 Administration of pneumococcal vaccine 659 649 $4K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,835 1,244 $4K
0202U Oncology (prostate), multianalyte, gene expression profiling 21 21 $4K
87660 626 452 $4K
86803 186 137 $4K
86780 318 239 $4K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,535 1,239 $3K
97597 40 12 $3K
83540 415 355 $3K
95819 29 21 $3K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 252 180 $3K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 221 176 $3K
93976 25 12 $3K
72125 Computed tomography, cervical spine; without contrast material 130 103 $3K
74018 55 41 $3K
J1050 Injection, medroxyprogesterone acetate, 1 mg 30 14 $3K
73610 140 107 $3K
87510 626 452 $3K
81003 1,301 1,006 $3K
86140 198 152 $3K
73030 153 124 $3K
85652 423 333 $3K
80326 411 351 $3K
83550 378 325 $3K
G0378 Hospital observation service, per hour 76 25 $3K
76705 Ultrasound, abdominal, real time with image documentation; limited 29 28 $2K
86900 95 59 $2K
82043 403 344 $2K
83735 907 658 $2K
90723 364 358 $2K
84484 2,630 1,586 $2K
90715 135 115 $2K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 2,274 1,638 $2K
86225 103 83 $2K
71045 Radiologic examination, chest; single view 1,344 1,084 $2K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 43 40 $2K
85610 1,033 770 $2K
71250 29 26 $2K
87186 447 346 $2K
80076 439 346 $2K
73130 120 97 $2K
86038 142 120 $1K
90633 135 135 $1K
90680 224 222 $1K
86850 82 59 $1K
83690 1,636 1,194 $1K
81025 814 615 $1K
88305 Level IV - Surgical pathology, gross and microscopic examination 353 211 $1K
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision 129 107 $1K
76801 32 24 $988.67
84703 701 499 $952.34
87807 191 164 $910.24
80347 117 109 $901.24
0011A 84 80 $856.80
96375 Therapeutic injection; each additional sequential IV push 1,620 1,055 $750.42
82947 745 379 $726.96
85730 505 411 $693.78
86431 52 42 $672.39
87077 79 64 $659.35
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 202 190 $585.67
90656 70 68 $571.93
87340 65 40 $535.93
90710 96 94 $493.35
0012A 63 63 $474.00
80355 118 110 $452.13
86901 94 59 $410.31
80320 53 43 $400.02
80364 116 108 $392.89
83037 26 26 $336.68
86147 49 25 $333.22
90674 16 15 $298.76
0031A 15 14 $288.80
83880 228 172 $249.28
86762 19 12 $243.32
86787 18 13 $218.82
82565 19 12 $210.37
85379 502 375 $187.68
85651 55 53 $185.85
85018 23 14 $131.78
90661 20 20 $129.82
J1885 Injection, ketorolac tromethamine, per 15 mg 2,212 1,438 $129.67
83605 967 628 $129.33
87088 16 14 $127.64
87040 352 158 $109.91
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 674 473 $104.45
87205 19 12 $103.91
73110 27 25 $84.05
96376 184 106 $67.31
J2704 Injection, propofol, 10 mg 1,404 767 $62.55
82150 174 120 $54.21
J2270 Injection, morphine sulfate, up to 10 mg 390 233 $36.66
81002 14 12 $36.28
80143 31 25 $34.87
85613 26 25 $23.36
J1100 Injection, dexamethasone sodium phosphate, 1 mg 2,023 1,477 $19.26
80179 31 25 $17.43
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 1,420 1,131 $15.21
J3010 Injection, fentanyl citrate, 0.1 mg 473 299 $13.90
J2405 Injection, ondansetron hydrochloride, per 1 mg 1,807 1,171 $9.77
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 242 174 $9.30
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 104 38 $8.38
J0690 Injection, cefazolin sodium, 500 mg 36 25 $4.38
J2250 Injection, midazolam hydrochloride, per 1 mg 211 131 $1.61
J0696 Injection, ceftriaxone sodium, per 250 mg 62 50 $0.97
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 1,107 930 $0.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 115 77 $0.00
J7030 Infusion, normal saline solution , 1000 cc 16 12 $0.00
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 15 12 $0.00
82248 20 17 $0.00
01936 44 38 $0.00
93892 56 56 $0.00
J1170 Injection, hydromorphone, up to 4 mg 22 13 $0.00
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 17 14 $0.00
J7050 Infusion, normal saline solution, 250 cc 29 14 $0.00