Hospital
Pottstown Hospital, LLC
Pottstown Hospital, LLC was paid $7.54M by Medicaid between Jan 2019 and Dec 2024, across 123 billing codes. Its largest line is 99284, emergency room visit (serious) — 46% of everything it billed.
33Billing provider infoPOTTSTOWN HOSPITAL, LLC
POTTSTOWN, PA 19464
POTTSTOWN, PA 19464
33aNPI1649794421assigned 08/02/2017
33bProvider typeGeneral Acute Care Hospital
28Total paid$7.54M
24GClaims94,848
24DCodes billed123
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Pennsylvania
Rank by total paid#42 of 154
Median peer was paid$2.82M
This provider vs. median2.7×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official RAYME, BRIAN controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
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
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 1,292 | $44K | |
| 2020 | 15,916 | $868K | |
| 2021 | 37,131 | $3.04M | |
| 2022 | 10,208 | $1.30M | |
| 2023 | 16,414 | $1.27M | |
| 2024incomplete | 13,887 | $1.01M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 46% | 16,050 | 15,152 | $3.44M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 34% | 11,933 | 11,480 | $2.59M |
| G0378 | Hospital observation service, per hour | 9.8% | 794 | 719 | $735K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 2.6% | 1,164 | 1,079 | $197K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.4% | 475 | 468 | $107K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 604 | 410 | $63K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 425 | 402 | $36K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 7,982 | 6,485 | $33K |
| 80053 | Comprehensive metabolic panel | <1% | 3,938 | 3,313 | $33K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | <1% | 572 | 266 | $26K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 78 | 77 | $25K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 94 | 93 | $23K |
111 more codes
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 1,885 | $22K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 716 | $18K |
| 87631 | <1% | 300 | $14K | |
| 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 | <1% | 299 | $13K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 2,299 | $13K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 961 | $12K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 472 | $11K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 95 | $10K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 753 | $9K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 1,545 | $8K |
| 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% | 291 | $7K |
| 96376 | <1% | 276 | $7K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 120 | $5K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 531 | $5K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 181 | $5K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 999 | $5K |
| 84484 | <1% | 1,221 | $4K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 568 | $4K |
| 83735 | <1% | 1,239 | $3K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 298 | $3K |
| 76830 | Ultrasound, transvaginal | <1% | 74 | $3K |
| 71045 | Radiologic examination, chest; single view | <1% | 941 | $3K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 28 | $3K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 95 | $3K |
| 73564 | <1% | 136 | $2K | |
| 93971 | <1% | 49 | $2K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,607 | $2K |
| 93975 | <1% | 30 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 149 | $2K |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 4,675 | $2K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 252 | $2K |
| 85610 | <1% | 747 | $1K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 38 | $1K |
| 81001 | <1% | 921 | $1K | |
| 80050 | General health panel | <1% | 26 | $1K |
| 83605 | <1% | 406 | $1K | |
| 81025 | <1% | 730 | $1K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 13 | $1K |
| 83880 | <1% | 96 | $1K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 338 | $968.48 |
| 83690 | <1% | 545 | $954.29 | |
| 71250 | <1% | 14 | $937.21 | |
| 85730 | <1% | 339 | $936.20 | |
| 80061 | Lipid panel | <1% | 109 | $871.14 |
| 85379 | <1% | 239 | $841.22 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 20 | $801.90 |
| 0002A | <1% | 23 | $771.00 | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 78 | $730.53 |
| 81003 | <1% | 644 | $721.85 | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 26 | $721.66 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,543 | $703.10 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 1,100 | $666.78 |
| 84703 | <1% | 115 | $613.00 | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 19 | $564.70 |
| 36415 | Collection of venous blood by venipuncture | <1% | 306 | $561.81 |
| 87077 | <1% | 193 | $560.48 | |
| 87040 | <1% | 82 | $547.68 | |
| 85027 | <1% | 76 | $533.81 | |
| 73030 | <1% | 54 | $519.20 | |
| 73610 | <1% | 46 | $498.86 | |
| 87641 | <1% | 14 | $418.84 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 44 | $417.44 |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 44 | $417.44 |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 3,016 | $416.08 |
| J2704 | Injection, propofol, 10 mg | <1% | 1,097 | $413.52 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,156 | $407.76 |
| 0001A | <1% | 23 | $400.66 | |
| 82550 | <1% | 206 | $389.44 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 59 | $387.74 |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 190 | $374.75 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 107 | $372.50 |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 13 | $361.69 |
| 86140 | <1% | 89 | $361.02 | |
| 82962 | <1% | 515 | $352.80 | |
| 73630 | <1% | 44 | $337.53 | |
| J3490 | Unclassified drugs | <1% | 887 | $325.51 |
| 87186 | <1% | 106 | $309.68 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 956 | $215.73 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 1,009 | $193.79 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 16 | $155.45 |
| 90714 | <1% | 13 | $140.56 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 578 | $140.38 |
| 84100 | <1% | 127 | $139.58 | |
| J2060 | Injection, lorazepam, 2 mg | <1% | 473 | $130.86 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 928 | $126.30 |
| 86900 | <1% | 57 | $122.50 | |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 13 | $116.34 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 409 | $108.96 |
| 82607 | <1% | 30 | $105.52 | |
| 82248 | <1% | 79 | $102.07 | |
| 85651 | <1% | 53 | $87.12 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 18 | $82.86 |
| 99406 | <1% | 15 | $81.20 | |
| 87420 | <1% | 14 | $77.14 | |
| 86901 | <1% | 30 | $59.55 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 179 | $58.49 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | <1% | 420 | $34.57 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 353 | $34.23 |
| J1815 | Injection, insulin, per 5 units | <1% | 51 | $31.89 |
| J1644 | Injection, heparin sodium, per 1000 units | <1% | 104 | $25.23 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | <1% | 370 | $4.60 |
| A6250 | Skin sealants, protectants, moisturizers, ointments, any type, any size | <1% | 12 | $0.80 |
| 00000 | 0% | 1,039 | $0.00 | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 0% | 12 | $0.00 |
| J1756 | Injection, iron sucrose, 1 mg | 0% | 368 | $0.00 |
| J7120 | Ringers lactate infusion, up to 1000 cc | 0% | 155 | $0.00 |
| C9113 | Injection, pantoprazole sodium, per vial | 0% | 55 | $0.00 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | 0% | 150 | $0.00 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 0% | 43 | $0.00 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 0% | 15 | $0.00 |
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 0% | 14 | $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 officialRAYME, BRIAN (EVP & CFO)
| Provider | Location | Paid |
|---|---|---|
| STC Opco LLC | Philadelphia, PA | $69.20M |
| Tower Health Urgent Care, LLC | Douglassville, PA | $11.77M |
| Phoenixville Hospital, LLC | Phoenixville, PA | $4.61M |
| Pottstown Clinic Company LLC | Pottstown, PA | $2.96M |
| Tower Drexel Academic Medical Group LLC | Philadelphia, PA | $2.47M |
| STC Opco LLC | Philadelphia, PA | $2.06M |
| STC Pediatrics LLC | Philadelphia, PA | $2.06M |
| STC Pediatrics LLC | Philadelphia, PA | $1.73M |
| Phoenixville Clinic Company LLC | Phoenixville, PA | $1.68M |
| STC Pediatrics LLC | Philadelphia, PA | $1.48M |
| STC Pediatrics LLC | Philadelphia, PA | $1.31M |
| Tower Health Medical Group | Wyomissing, PA | $1.28M |
| STC Pediatrics LLC | Philadelphia, PA | $988K |
| Tower Health Medical Group | West Reading, PA | $850K |
| Tower Health Medical Group | West Reading, PA | $724K |
| Tower Health Medical Group | West Reading, PA | $720K |
| Tower Health Medical Group | Birdsboro, PA | $543K |
| STC Pediatrics LLC | Philadelphia, PA | $497K |
| STC Pediatrics LLC | Philadelphia, PA | $462K |
| STC Pediatrics LLC | Philadelphia, PA | $449K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.