Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NH › LEBANON › MARY HITCHCOCK MEMORIAL HOSPITAL

MARY HITCHCOCK MEMORIAL HOSPITAL

NPI: 1629788237 · LEBANON, NH 03756 · Internal Medicine Physician · NPI assigned 12/05/2022

$3.75M
Total Medicaid Paid
143,991
Total Claims
131,255
Beneficiaries
212
Codes Billed
2023-06
First Month
2024-12
Last Month

Provider Details

Authorized OfficialFIELDING, WENDY (CHIEF FINANCIAL OFFICER)
Parent OrganizationMARY HITCHCOCK MEMORIAL HOSPITAL
NPI Enumeration Date12/05/2022

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 43,749 $1.23M
2024 100,242 $2.52M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 29,405 27,129 $1.62M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 19,089 17,875 $748K
99215 Prolong outpt/office vis 2,433 2,286 $143K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,927 1,888 $129K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,575 1,544 $103K
99244 Office or other outpatient consultation, moderate to high complexity 888 867 $80K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,076 1,043 $73K
J0585 Injection, onabotulinumtoxina, 1 unit 709 399 $70K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 471 392 $55K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 9,221 8,955 $49K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 14,057 11,326 $44K
74018 1,828 1,728 $29K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 519 498 $29K
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) 2,770 2,634 $28K
77067 Screening mammography, bilateral, including computer-aided detection 231 227 $27K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 665 634 $25K
71046 Radiologic examination, chest; 2 views 1,728 1,620 $24K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 355 346 $24K
99205 Prolong outpt/office vis 246 239 $19K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 155 146 $19K
99245 154 153 $19K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 474 367 $18K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 200 183 $17K
99284 Emergency department visit for the evaluation and management, high severity 241 218 $17K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 232 207 $17K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 471 347 $17K
74177 Computed tomography, abdomen and pelvis; with contrast material 238 224 $17K
90472 Immunization administration, each additional vaccine (list separately) 3,089 3,001 $16K
76830 Ultrasound, transvaginal 302 280 $15K
93000 933 902 $14K
92567 1,742 1,702 $13K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 689 644 $13K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 600 444 $13K
93325 358 332 $11K
76770 210 198 $11K
92558 614 587 $9K
77063 Screening digital breast tomosynthesis, bilateral 231 227 $8K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 351 333 $8K
93320 154 146 $8K
99243 98 98 $8K
92579 437 431 $8K
64615 127 120 $6K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 271 210 $5K
76819 Fetal biophysical profile; without non-stress testing 90 51 $5K
90837 Psychotherapy, 53 minutes with patient 52 36 $5K
94010 292 278 $5K
71260 Computed tomography, thorax, diagnostic; with contrast material 90 87 $5K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 907 833 $5K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 87 85 $4K
83036 Hemoglobin; glycosylated (A1C) 1,382 1,353 $4K
99173 524 499 $3K
90686 2,291 2,232 $3K
20610 216 193 $3K
95117 266 189 $3K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 160 132 $2K
70450 Computed tomography, head or brain; without contrast material 81 78 $2K
96375 Therapeutic injection; each additional sequential IV push 327 248 $2K
76700 Ultrasound, abdominal, real time with image documentation; complete 25 24 $2K
92557 125 121 $2K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 278 219 $2K
96361 Intravenous infusion, hydration; each additional hour 206 97 $2K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 2,768 2,367 $2K
A9575 Injection, gadoterate meglumine, 0.1 ml 467 445 $2K
80053 Comprehensive metabolic panel 2,269 2,048 $2K
G0444 Annual depression screening, 5 to 15 minutes 203 195 $2K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 792 738 $2K
51741 140 130 $2K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 180 171 $2K
76705 Ultrasound, abdominal, real time with image documentation; limited 50 40 $2K
88305 Level IV - Surgical pathology, gross and microscopic examination 422 407 $2K
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 135 125 $2K
51798 139 129 $2K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 769 634 $2K
99177 105 105 $2K
87631 36 35 $2K
97802 24 24 $1K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 33 27 $1K
J7030 Infusion, normal saline solution , 1000 cc 781 531 $1K
90460 Immunization administration through 18 years of age via any route, first or only component 237 209 $1K
84443 Thyroid stimulating hormone (TSH) 1,060 1,023 $1K
81002 798 769 $1K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 26 12 $1K
90791 Psychiatric diagnostic evaluation 12 12 $1K
90656 1,335 1,314 $1K
90834 Psychotherapy, 45 minutes with patient 14 12 $1K
92587 35 35 $974.31
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 13 13 $953.40
D7240 Removal of impacted tooth - completely bony 115 113 $902.26
90792 Psychiatric diagnostic evaluation with medical services 14 14 $893.92
90832 Psychotherapy, 30 minutes with patient 31 25 $874.81
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 27 27 $838.35
91322 96 94 $807.61
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 414 407 $755.53
J7050 Infusion, normal saline solution, 250 cc 910 542 $657.21
J2704 Injection, propofol, 10 mg 383 368 $643.84
80048 Basic metabolic panel (calcium, ionized) 1,015 865 $633.16
80061 Lipid panel 696 688 $596.21
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 120 63 $579.69
99242 16 13 $566.06
82728 457 411 $526.50
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 34 31 $508.66
76376 13 13 $504.08
73030 55 50 $474.87
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 17 16 $474.46
95251 41 37 $466.96
59025 Fetal non-stress test 18 12 $466.65
83655 42 41 $457.08
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 13 12 $423.84
83735 363 288 $384.65
97803 12 12 $383.96
87077 277 269 $362.79
73630 15 13 $356.14
73564 31 28 $336.10
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 59 58 $314.62
82570 276 270 $314.47
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 60 59 $294.12
90474 89 87 $291.54
84439 321 297 $286.97
90677 517 508 $245.76
82607 375 371 $239.61
71250 13 13 $215.82
17110 12 12 $215.52
64405 15 12 $215.42
87086 Culture, bacterial; quantitative colony count, urine 409 388 $209.32
96110 Developmental screening, with scoring and documentation, per standardized instrument 37 36 $208.68
83970 126 118 $187.84
84100 246 183 $180.59
82746 124 121 $179.79
86140 318 295 $172.34
86850 58 47 $170.18
83880 42 41 $166.94
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 124 80 $166.30
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 28 28 $162.86
85027 210 204 $146.16
90480 111 109 $145.95
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 28 26 $144.74
83550 398 386 $141.05
87070 105 104 $129.73
81001 327 304 $127.16
83615 136 92 $119.28
82962 386 288 $118.72
82784 117 80 $117.21
83540 400 388 $109.99
92552 13 13 $109.98
85610 325 290 $109.67
80076 161 156 $106.27
J7120 Ringers lactate infusion, up to 1000 cc 771 613 $104.32
83690 109 100 $97.20
82043 183 178 $90.48
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 12 12 $80.12
96040 207 205 $72.48
J1100 Injection, dexamethasone sodium phosphate, 1 mg 338 294 $71.67
J2405 Injection, ondansetron hydrochloride, per 1 mg 530 413 $70.63
82040 112 111 $62.82
92555 12 12 $62.04
87186 132 128 $61.57
85652 277 266 $58.23
J3010 Injection, fentanyl citrate, 0.1 mg 396 349 $51.78
86901 69 57 $50.40
86900 69 57 $50.40
82248 67 65 $50.05
96161 65 65 $48.44
82565 96 91 $42.13
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 13 13 $38.39
84484 46 42 $37.04
81003 192 177 $35.28
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 13 13 $33.62
85018 14 14 $29.64
84550 64 50 $27.49
11721 13 13 $26.74
88342 32 30 $20.54
J0690 Injection, cefazolin sodium, 500 mg 138 118 $18.82
J1885 Injection, ketorolac tromethamine, per 15 mg 312 241 $16.19
84460 12 12 $13.67
84450 12 12 $13.36
85730 14 13 $11.28
84156 28 26 $10.14
36591 31 19 $9.91
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 31 12 $9.00
87205 27 27 $8.04
J1170 Injection, hydromorphone, up to 4 mg 64 38 $7.30
J2250 Injection, midazolam hydrochloride, per 1 mg 331 311 $6.89
J2003 Injection, lidocaine hydrochloride, 1 mg 79 73 $2.92
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 196 153 $1.96
73502 41 41 $1.51
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 12 12 $0.76
36415 Collection of venous blood by venipuncture 3,907 3,575 $0.00
86364 15 14 $0.00
G0008 Administration of influenza virus vaccine 549 549 $0.00
90680 90 89 $0.00
J3490 Unclassified drugs 67 40 $0.00
90694 67 67 $0.00
90697 258 254 $0.00
G0009 Administration of pneumococcal vaccine 57 57 $0.00
C1769 Guide wire 16 13 $0.00
90619 12 12 $0.00
J2469 Injection, palonosetron hcl, 25 mcg 16 12 $0.00
88341 13 12 $0.00
G0499 Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result 12 12 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 17 12 $0.00
73610 13 13 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 191 189 $0.00
90670 74 68 $0.00
95874 77 76 $0.00
72100 13 13 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 202 184 $0.00
80164 12 12 $0.00
84165 12 12 $0.00
90653 93 93 $0.00
90633 12 12 $0.00
90681 26 25 $0.00
69210 13 13 $0.00