Rochester General Hospital
Rochester General Hospital was paid $281K by Medicaid between Jun 2018 and Nov 2024, across 12 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 38% of everything it billed.
ROCHESTER, NY 14621
Next to other Critical Care Medicine (Anesthesiology) Physician providers in New York
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 127 | $5K | |
| 2019 | 205 | $19K | |
| 2020 | 265 | $27K | |
| 2021 | 564 | $82K | |
| 2022 | 366 | $41K | |
| 2023 | 897 | $90K | |
| 2024incomplete | 193 | $17K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 38% | 653 | 181 | $106K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 19% | 451 | 451 | $55K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 14% | 310 | 310 | $39K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 8.6% | 295 | 295 | $24K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.4% | 411 | 389 | $15K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.8% | 221 | 218 | $13K |
| 47562 | 4.7% | 27 | 27 | $13K | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 3.9% | 122 | 122 | $11K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 1.3% | 41 | 41 | $4K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | <1% | 17 | 17 | $773.16 |
| 96127 | <1% | 14 | 12 | $63.56 | |
| 99024 | 0% | 55 | 48 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.