Hospital
Prime Healthcare Services - Monroe LLC
Prime Healthcare Services - Monroe LLC was paid $5.67M by Medicaid between Jan 2018 and Nov 2024, across 67 billing codes. Its largest line is 99283, emergency room visit (moderate) — 48% of everything it billed.
33Billing provider infoPRIME HEALTHCARE SERVICES - MONROE LLC
BLOOMINGTON, IN 47403
BLOOMINGTON, IN 47403
33aNPI1740686443assigned 11/07/2014
33bProvider typeGeneral Acute Care Hospital
28Total paid$5.67M
24GClaims90,290
24DCodes billed67
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in Indiana
Rank by total paid#45 of 69
Median peer was paid$9.76M
This provider vs. median0.6×
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 | 9,725 | $182K | |
| 2019 | 9,409 | $431K | |
| 2020 | 8,360 | $415K | |
| 2021 | 13,177 | $742K | |
| 2022 | 17,948 | $1.21M | |
| 2023 | 18,940 | $1.54M | |
| 2024incomplete | 12,731 | $1.15M |
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 | 48% | 18,792 | 16,277 | $2.72M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 18% | 9,938 | 8,266 | $1.04M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 9.6% | 5,923 | 4,981 | $547K |
| 71045 | Radiologic examination, chest; single view | 5.2% | 1,947 | 1,683 | $292K |
| 96361 | Intravenous infusion, hydration; each additional hour | 3.5% | 1,234 | 1,017 | $201K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2.6% | 321 | 271 | $147K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 2.2% | 3,059 | 2,474 | $126K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.0% | 2,261 | 1,770 | $114K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 1.8% | 1,417 | 1,218 | $102K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.6% | 1,918 | 1,706 | $89K |
| 80053 | Comprehensive metabolic panel | 1.2% | 11,267 | 9,411 | $69K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.0% | 12,644 | 10,492 | $57K |
55 more codes
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 536 | $49K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 252 | $25K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 145 | $25K |
| 87449 | <1% | 1,364 | $10K | |
| 84484 | <1% | 1,221 | $9K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 49 | $6K |
| 83690 | <1% | 1,271 | $5K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 1,152 | $5K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 534 | $3K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 72 | $3K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 156 | $2K |
| 81001 | <1% | 1,447 | $2K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,611 | $2K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 438 | $2K |
| 80061 | Lipid panel | <1% | 321 | $2K |
| 83880 | <1% | 111 | $2K | |
| 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% | 36 | $2K |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 309 | $2K |
| 81025 | <1% | 222 | $2K | |
| 84439 | <1% | 428 | $1K | |
| 80305 | <1% | 163 | $1K | |
| 82746 | <1% | 209 | $1K | |
| 82728 | <1% | 190 | $954.12 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 120 | $721.52 |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 105 | $680.33 |
| 83550 | <1% | 189 | $602.69 | |
| 82977 | <1% | 289 | $598.25 | |
| 84703 | <1% | 108 | $597.90 | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 14 | $591.24 |
| 81003 | <1% | 415 | $569.11 | |
| 86140 | <1% | 164 | $553.35 | |
| 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% | 20 | $539.84 |
| 83540 | <1% | 189 | $446.42 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 13 | $407.19 |
| 82150 | <1% | 110 | $380.38 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 71 | $350.55 |
| 83735 | <1% | 113 | $289.98 | |
| 85652 | <1% | 135 | $250.62 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 53 | $182.54 |
| 85379 | <1% | 12 | $92.99 | |
| 85730 | <1% | 32 | $77.59 | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 17 | $62.14 |
| 85610 | <1% | 33 | $59.67 | |
| 82607 | <1% | 38 | $36.10 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,407 | $15.82 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 13 | $0.00 |
| Q0162 | Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | 0% | 14 | $0.00 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 19 | $0.00 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 0% | 660 | $0.00 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 0% | 1,130 | $0.00 |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | 0% | 698 | $0.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 88 | $0.00 |
| J1650 | Injection, enoxaparin sodium, 10 mg | 0% | 15 | $0.00 |
| J7120 | Ringers lactate infusion, up to 1000 cc | 0% | 33 | $0.00 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 0% | 15 | $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 officialBAKEWELL, NANCY (ADMINISTRATOR)