Hospital
ST. Nicholas Hospital-Sisters of the Third Order of ST Francis
ST. Nicholas Hospital-Sisters of the Third Order of ST Francis was paid $5.04M by Medicaid between Jan 2018 and Dec 2024, across 142 billing codes. Its largest line is 99283, emergency room visit (moderate) — 14% of everything it billed.
33Billing provider infoST. NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST FRANCIS
SHEBOYGAN, WI 53081
SHEBOYGAN, WI 53081
33aNPI1730184342assigned 06/20/2005
33bProvider typeGeneral Acute Care Hospital
28Total paid$5.04M
24GClaims256,560
24DCodes billed142
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Wisconsin
Rank by total paid#25 of 60
Median peer was paid$2.90M
This provider vs. median1.7×
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 ALLEN, PATRICIA controls 18+ 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 | |
|---|---|---|---|
| 2018 | 31,083 | $571K | |
| 2019 | 32,535 | $600K | |
| 2020 | 29,665 | $549K | |
| 2021 | 41,602 | $696K | |
| 2022 | 46,819 | $902K | |
| 2023 | 44,434 | $928K | |
| 2024incomplete | 30,422 | $792K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 14% | 12,197 | 10,570 | $692K |
| 96361 | Intravenous infusion, hydration; each additional hour | 12% | 5,471 | 4,146 | $602K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 9.5% | 10,433 | 8,748 | $478K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 6.4% | 1,380 | 1,200 | $324K |
| 41899 | Unlisted procedure, dentoalveolar structures | 6.3% | 776 | 665 | $319K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 4.9% | 4,215 | 3,061 | $248K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.8% | 5,811 | 4,925 | $240K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 4.4% | 3,787 | 3,350 | $220K |
| 80053 | Comprehensive metabolic panel | 3.9% | 10,757 | 8,767 | $196K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 3.3% | 2,794 | 2,454 | $165K |
| 70450 | Computed tomography, head or brain; without contrast material | 2.6% | 2,546 | 2,233 | $131K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 2.3% | 1,555 | 1,343 | $116K |
130 more codes
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 2.1% | 596 | $105K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.9% | 16,282 | $96K |
| 80048 | Basic metabolic panel (calcium, ionized) | 1.6% | 6,056 | $81K |
| 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 | 1.4% | 1,633 | $70K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.3% | 1,750 | $64K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 1.2% | 2,394 | $61K |
| G0378 | Hospital observation service, per hour | 1.0% | 1,095 | $52K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 1,460 | $44K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 472 | $40K |
| 84484 | <1% | 5,153 | $40K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,451 | $40K |
| 80306 | <1% | 1,618 | $39K | |
| 81025 | <1% | 4,213 | $38K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,567 | $37K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 600 | $37K |
| 87486 | <1% | 1,381 | $35K | |
| 81001 | <1% | 8,720 | $34K | |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 470 | $32K |
| 87581 | <1% | 1,378 | $31K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 142 | $27K |
| 83605 | <1% | 2,932 | $19K | |
| 83690 | <1% | 3,823 | $19K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,876 | $19K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 206 | $18K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 620 | $17K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 2,643 | $14K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,055 | $14K |
| 80076 | <1% | 2,229 | $13K | |
| 83880 | <1% | 602 | $11K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 112 | $10K |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 538 | $10K |
| 83735 | <1% | 2,578 | $9K | |
| 85379 | <1% | 1,245 | $9K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 396 | $8K |
| 87040 | <1% | 1,610 | $8K | |
| 82805 | <1% | 374 | $8K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 181 | $7K |
| 85610 | <1% | 2,215 | $7K | |
| 86140 | <1% | 1,437 | $6K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 181 | $6K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 370 | $6K |
| 87081 | <1% | 302 | $5K | |
| 94664 | <1% | 215 | $5K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 98 | $5K |
| 87077 | <1% | 588 | $5K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 7,696 | $4K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 383 | $4K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 103 | $4K |
| 85730 | <1% | 932 | $3K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 29 | $3K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 8,302 | $2K |
| 87186 | <1% | 451 | $2K | |
| 85652 | <1% | 918 | $2K | |
| 80061 | Lipid panel | <1% | 79 | $2K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 6,878 | $2K |
| 71045 | Radiologic examination, chest; single view | <1% | 3,875 | $2K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,115 | $2K |
| 86850 | <1% | 72 | $1K | |
| 97597 | <1% | 80 | $1K | |
| J0134 | Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg | <1% | 109 | $1K |
| 84439 | <1% | 133 | $1K | |
| 93971 | <1% | 41 | $1K | |
| 85027 | <1% | 97 | $944.34 | |
| 84702 | <1% | 57 | $709.52 | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | <1% | 12 | $694.82 |
| G0379 | Direct admission of patient for hospital observation care | <1% | 14 | $654.09 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 55 | $629.37 |
| 82565 | <1% | 53 | $591.40 | |
| 87807 | <1% | 43 | $472.57 | |
| 94060 | <1% | 30 | $335.04 | |
| 86901 | <1% | 118 | $241.21 | |
| 86900 | <1% | 118 | $241.21 | |
| 94729 | <1% | 86 | $240.59 | |
| 87088 | <1% | 42 | $239.95 | |
| 87210 | <1% | 42 | $175.56 | |
| 94726 | <1% | 27 | $152.17 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,114 | $117.29 |
| 87070 | <1% | 18 | $71.02 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 2,652 | $69.13 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 5,938 | $53.02 |
| 81003 | <1% | 48 | $45.03 | |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | <1% | 32 | $42.22 |
| 87205 | <1% | 18 | $35.55 | |
| 73630 | <1% | 76 | $34.60 | |
| 96376 | <1% | 2,055 | $23.59 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 1,370 | $22.86 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 5,644 | $21.24 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 7,345 | $20.76 |
| J3490 | Unclassified drugs | <1% | 3,480 | $13.37 |
| C9113 | Injection, pantoprazole sodium, per vial | <1% | 34 | $12.45 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 6,005 | $7.68 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 3,824 | $5.99 |
| P9612 | Catheterization for collection of specimen, single patient, all places of service | <1% | 100 | $5.53 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 5,853 | $5.10 |
| 73030 | <1% | 14 | $4.47 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 4,161 | $3.16 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 762 | $2.60 |
| J3475 | Injection, magnesium sulfate, per 500 mg | <1% | 55 | $2.05 |
| J2704 | Injection, propofol, 10 mg | <1% | 3,575 | $1.30 |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 2,408 | $0.74 |
| 88304 | <1% | 16 | $0.47 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 3,156 | $0.09 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | <1% | 935 | $0.01 |
| A9270 | Non-covered item or service | 0% | 1,753 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 241 | $0.00 |
| J7050 | Infusion, normal saline solution, 250 cc | 0% | 858 | $0.00 |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 0% | 1,170 | $0.00 |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 0% | 41 | $0.00 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 0% | 1,041 | $0.00 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 542 | $0.00 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 0% | 220 | $0.00 |
| J3360 | Injection, diazepam, up to 5 mg | 0% | 44 | $0.00 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 121 | $0.00 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 70 | $0.00 |
| Q9969 | Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose | 0% | 13 | $0.00 |
| A9577 | Injection, gadobenate dimeglumine (multihance), per ml | 0% | 1,067 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 2,309 | $0.00 |
| 88312 | 0% | 255 | $0.00 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 1,869 | $0.00 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 0% | 37 | $0.00 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 0% | 49 | $0.00 |
| J0689 | Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg | 0% | 229 | $0.00 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 0% | 130 | $0.00 |
| J0136 | Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg | 0% | 61 | $0.00 |
| 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 | 0% | 34 | $0.00 |
| J0137 | Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg | 0% | 48 | $0.00 |
| J1650 | Injection, enoxaparin sodium, 10 mg | 0% | 29 | $0.00 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 0% | 32 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 0% | 23 | $0.00 |
| 73610 | 0% | 17 | $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 officialALLEN, PATRICIA (CFO)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.