Physician
ST. Charles Health System, INC.
ST. Charles Health System, INC. was paid $1.37M by Medicaid between Jan 2018 and Nov 2024, across 89 billing codes. Its largest line is 99284, emergency room visit (serious) — 51% of everything it billed.
33Billing provider infoST. CHARLES HEALTH SYSTEM, INC.
PRINEVILLE, OR 97754
PRINEVILLE, OR 97754
33aNPI1710160445assigned 12/17/2007
33bProvider typeEmergency Medicine Physician
28Total paid$1.37M
24GClaims94,305
24DCodes billed89
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Emergency Medicine Physician providers in Oregon
Rank by total paid#18 of 57
Median peer was paid$62K
This provider vs. median22×
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.
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 | |
|---|---|---|---|
| 2018 | 27,721 | $240K | |
| 2019 | 12,465 | $218K | |
| 2020 | 7,180 | $119K | |
| 2021 | 12,005 | $159K | |
| 2022 | 13,321 | $221K | |
| 2023 | 12,549 | $205K | |
| 2024incomplete | 9,064 | $211K |
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 | 51% | 10,979 | 7,943 | $698K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 33% | 14,795 | 10,762 | $458K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 6.7% | 4,747 | 3,557 | $92K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 3.5% | 747 | 545 | $48K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 1.1% | 1,703 | 1,632 | $15K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 11,431 | 10,312 | $9K |
| 80053 | Comprehensive metabolic panel | <1% | 11,187 | 10,237 | $8K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 1,825 | 1,680 | $7K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 1,089 | 972 | $6K |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 1,183 | 953 | $4K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 688 | 619 | $4K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 549 | 496 | $3K |
77 more codes
| 36415 | Collection of venous blood by venipuncture | <1% | 14,909 | $2K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 573 | $2K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 409 | $2K |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 397 | $2K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 28 | $2K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 460 | $2K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 437 | $1K |
| 81001 | <1% | 1,494 | $884.33 | |
| J2704 | Injection, propofol, 10 mg | <1% | 823 | $759.41 |
| 80061 | Lipid panel | <1% | 2,102 | $753.40 |
| 83690 | <1% | 478 | $625.60 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,794 | $541.33 |
| 83605 | <1% | 283 | $383.15 | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 323 | $368.08 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 245 | $350.17 |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 93 | $333.15 |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 260 | $282.85 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 893 | $246.50 |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 520 | $192.23 |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 149 | $158.78 |
| 84703 | <1% | 154 | $139.27 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 163 | $126.11 |
| 87070 | <1% | 379 | $106.37 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 591 | $89.35 |
| 96376 | <1% | 78 | $84.87 | |
| 87276 | <1% | 171 | $83.43 | |
| 87275 | <1% | 171 | $83.37 | |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 59 | $76.06 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 259 | $69.03 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 14 | $67.06 |
| 87088 | <1% | 218 | $59.20 | |
| 84484 | <1% | 312 | $50.17 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 101 | $49.95 |
| 87077 | <1% | 227 | $46.03 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 246 | $41.95 |
| 85610 | <1% | 188 | $40.27 | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 114 | $33.72 |
| 87186 | <1% | 179 | $32.30 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 190 | $25.78 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 130 | $20.28 |
| 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% | 111 | $16.82 |
| 81025 | <1% | 105 | $15.33 | |
| 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% | 110 | $13.24 |
| 85027 | <1% | 170 | $9.47 | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 129 | $8.37 |
| 87205 | <1% | 45 | $4.99 | |
| 87147 | <1% | 48 | $3.91 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 39 | $2.70 |
| 82962 | <1% | 74 | $2.00 | |
| 85652 | <1% | 176 | $1.89 | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 0% | 329 | $0.00 |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 0% | 46 | $0.00 |
| 86038 | 0% | 15 | $0.00 | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 0% | 142 | $0.00 |
| 84439 | 0% | 143 | $0.00 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 0% | 64 | $0.00 |
| 73630 | 0% | 15 | $0.00 | |
| 82565 | 0% | 54 | $0.00 | |
| 84466 | 0% | 29 | $0.00 | |
| 83540 | 0% | 30 | $0.00 | |
| 71045 | Radiologic examination, chest; single view | 0% | 26 | $0.00 |
| 82728 | 0% | 46 | $0.00 | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 0% | 113 | $0.00 |
| 87430 | 0% | 62 | $0.00 | |
| 86140 | 0% | 132 | $0.00 | |
| 85379 | 0% | 50 | $0.00 | |
| 87081 | 0% | 101 | $0.00 | |
| 76830 | Ultrasound, transvaginal | 0% | 45 | $0.00 |
| 82043 | 0% | 63 | $0.00 | |
| 86803 | 0% | 46 | $0.00 | |
| 87807 | 0% | 29 | $0.00 | |
| 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 | 0% | 35 | $0.00 |
| G0475 | Hiv antigen/antibody, combination assay, screening | 0% | 34 | $0.00 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 66 | $0.00 |
| 82607 | 0% | 17 | $0.00 | |
| 82746 | 0% | 15 | $0.00 | |
| 83735 | 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 officialSWAFFORD, MATTHEW (CFO)
| Provider | Location | Paid |
|---|---|---|
| ST. Charles Health System, INC. | Bend, OR | $8.55M |
| ST. Charles Health System, INC. | Madras, OR | $4.96M |
| ST. Charles Health System, INC. | Bend, OR | $1.38M |
| ST. Charles Health System, INC. | Bend, OR | $539K |
| ST. Charles Health System, INC. | Prineville, OR | $291K |
| ST. Charles Health System, INC. | Bend, OR | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.