Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WA › CLARKSTON › TRI-STATE MEMORIAL HOSPITAL

TRI-STATE MEMORIAL HOSPITAL

NPI: 1760485221 · CLARKSTON, WA 99403 · Critical Access Hospital · NPI assigned 05/27/2005

$14.46M
Total Medicaid Paid
362,680
Total Claims
309,793
Beneficiaries
207
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialTOWN, ALEX (CFO)
NPI Enumeration Date05/27/2005

Related Entities

Other providers sharing the same authorized official: TOWN, ALEX

ProviderCityStateTotal Paid
TRI-STATE MEMORIAL HOSPITAL CLARKSTON WA $3.72M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 59,606 $2.05M
2019 57,744 $2.08M
2020 46,626 $1.99M
2021 52,080 $1.92M
2022 55,780 $2.20M
2023 52,149 $2.27M
2024 38,695 $1.94M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 9,389 7,386 $2.78M
99283 Emergency department visit for the evaluation and management, moderate severity 11,004 9,409 $2.04M
74177 Computed tomography, abdomen and pelvis; with contrast material 1,813 1,632 $1.17M
99282 Emergency department visit for the evaluation and management, low to moderate severity 6,961 6,528 $923K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 1,198 988 $523K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 6,250 5,481 $427K
70450 Computed tomography, head or brain; without contrast material 1,639 1,413 $368K
80053 Comprehensive metabolic panel 14,721 12,755 $323K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 6,546 5,453 $252K
99281 Emergency department visit for the evaluation and management, self-limited or minor 3,185 2,970 $246K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 17,507 15,091 $232K
71046 Radiologic examination, chest; 2 views 3,404 2,910 $208K
62323 749 435 $199K
71045 Radiologic examination, chest; single view 3,380 2,708 $183K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 14,547 13,289 $159K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 3,087 1,767 $158K
96375 Therapeutic injection; each additional sequential IV push 4,601 3,925 $154K
84484 2,857 2,444 $143K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 18,223 15,426 $137K
80047 3,317 2,996 $115K
74176 Computed tomography, abdomen and pelvis; without contrast material 235 203 $108K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 5,349 4,496 $103K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,608 7,234 $102K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,849 6,155 $94K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 17,460 14,870 $89K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,530 1,406 $89K
87641 1,208 1,133 $85K
97597 1,422 482 $85K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 785 716 $84K
80050 General health panel 1,182 1,152 $77K
36415 Collection of venous blood by venipuncture 19,665 16,494 $76K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 1,910 1,720 $76K
84443 Thyroid stimulating hormone (TSH) 3,603 3,373 $73K
96361 Intravenous infusion, hydration; each additional hour 2,640 2,386 $73K
83605 2,370 2,057 $72K
76705 Ultrasound, abdominal, real time with image documentation; limited 426 385 $71K
83690 3,127 2,826 $69K
81001 5,771 5,242 $66K
43248 84 82 $65K
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 1,560 1,432 $65K
77067 Screening mammography, bilateral, including computer-aided detection 458 446 $63K
87086 Culture, bacterial; quantitative colony count, urine 3,790 3,432 $61K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,037 937 $61K
87186 2,450 2,188 $61K
87428 2,007 1,913 $61K
73630 720 623 $55K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,187 1,137 $54K
J7030 Infusion, normal saline solution , 1000 cc 6,382 4,728 $53K
81025 3,347 3,077 $51K
62321 151 89 $49K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 3,132 2,896 $49K
87077 2,766 2,473 $48K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,931 2,840 $48K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 80 77 $46K
64483 135 87 $42K
51798 625 537 $42K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,814 1,687 $41K
80061 Lipid panel 2,964 2,806 $41K
96376 1,064 905 $36K
73610 429 386 $35K
82803 838 707 $34K
71250 147 129 $34K
84145 416 380 $34K
85014 3,554 3,210 $33K
81003 8,703 7,716 $31K
83880 645 593 $29K
86140 2,927 2,698 $27K
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 346 299 $27K
11721 1,917 1,350 $27K
80048 Basic metabolic panel (calcium, ionized) 1,768 1,634 $26K
87040 762 538 $26K
83036 Hemoglobin; glycosylated (A1C) 3,553 3,298 $25K
85652 2,281 2,126 $24K
73130 298 245 $24K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1,266 1,165 $24K
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 1,522 1,302 $23K
85610 1,931 1,636 $22K
11056 745 451 $21K
82077 400 359 $21K
80305 2,496 2,119 $21K
87070 1,756 1,564 $21K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 118 115 $20K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 27 25 $18K
87205 1,354 1,162 $18K
85379 271 267 $18K
73562 225 198 $17K
Q3014 Telehealth originating site facility fee 2,068 1,953 $16K
83735 1,680 1,440 $16K
J7060 5% dextrose/water (500 ml = 1 unit) 2,067 1,428 $15K
80076 647 610 $15K
J7050 Infusion, normal saline solution, 250 cc 2,250 1,417 $15K
76830 Ultrasound, transvaginal 82 81 $14K
J7120 Ringers lactate infusion, up to 1000 cc 1,814 1,447 $14K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 2,428 2,133 $14K
J2250 Injection, midazolam hydrochloride, per 1 mg 5,062 4,357 $13K
74019 226 187 $13K
85027 1,169 1,073 $13K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 125 123 $12K
72125 Computed tomography, cervical spine; without contrast material 42 40 $12K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 337 192 $11K
73030 176 157 $11K
72100 180 150 $11K
80299 104 92 $10K
J3010 Injection, fentanyl citrate, 0.1 mg 2,793 2,080 $10K
73110 123 107 $10K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 860 816 $10K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 845 804 $10K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 1,121 1,055 $9K
82553 232 219 $9K
J1170 Injection, hydromorphone, up to 4 mg 2,470 1,711 $8K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 599 576 $8K
82550 514 488 $8K
J1885 Injection, ketorolac tromethamine, per 15 mg 4,461 3,945 $7K
84439 705 667 $7K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 12 12 $7K
85007 597 550 $7K
J2405 Injection, ondansetron hydrochloride, per 1 mg 5,248 4,093 $7K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 653 549 $7K
71275 Computed tomographic angiography, chest, with contrast material 13 13 $6K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 2,471 2,256 $6K
J0690 Injection, cefazolin sodium, 500 mg 1,115 753 $6K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 1,186 1,095 $6K
83874 128 123 $5K
85730 208 196 $4K
J0696 Injection, ceftriaxone sodium, per 250 mg 1,794 1,263 $4K
76700 Ultrasound, abdominal, real time with image documentation; complete 34 28 $4K
94729 72 66 $4K
82570 605 568 $3K
36416 1,604 1,360 $3K
82075 213 179 $3K
82607 201 196 $3K
94060 30 27 $3K
82150 171 152 $3K
86803 217 208 $3K
87081 219 216 $2K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 145 124 $2K
84703 136 124 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 244 208 $2K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 176 175 $2K
20610 35 25 $2K
82565 63 60 $2K
84550 237 185 $2K
82043 188 184 $2K
87340 150 147 $1K
80143 15 12 $1K
94726 46 41 $1K
86235 44 39 $1K
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 1,737 1,599 $1K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 41 41 $1K
J2270 Injection, morphine sulfate, up to 10 mg 299 226 $1K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 164 94 $1K
83970 54 52 $1K
82805 30 25 $1K
84481 84 82 $1K
83540 145 136 $1K
73502 38 13 $1K
74018 13 12 $976.34
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,036 883 $935.28
87807 14 13 $933.57
J3475 Injection, magnesium sulfate, per 500 mg 230 219 $924.23
84100 191 139 $902.22
82728 74 69 $889.80
86038 99 92 $841.43
J2550 Injection, promethazine hcl, up to 50 mg 458 379 $778.45
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 125 108 $767.69
J2060 Injection, lorazepam, 2 mg 694 498 $700.76
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 979 721 $689.84
86039 53 50 $654.42
84153 38 38 $649.79
62369 24 12 $624.49
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 80 68 $617.02
J3370 Injection, vancomycin hcl, 500 mg 37 14 $569.20
36600 69 65 $540.28
96127 957 871 $532.40
J0780 Injection, prochlorperazine, up to 10 mg 106 99 $529.98
90715 13 12 $491.86
86160 14 12 $487.99
84156 82 74 $479.48
86704 54 53 $453.29
86200 28 27 $445.18
J2765 Injection, metoclopramide hcl, up to 10 mg 137 98 $428.43
87210 39 38 $399.88
86431 49 45 $381.65
83550 58 53 $352.11
80069 26 25 $341.88
80320 82 72 $332.65
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 117 115 $314.33
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 58 54 $309.62
G0103 Prostate cancer screening; prostate specific antigen test (psa) 48 40 $308.12
A6197 Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing 107 52 $204.51
82375 13 13 $191.87
99215 Prolong outpt/office vis 12 12 $174.88
J2175 Injection, meperidine hydrochloride, per 100 mg 38 24 $168.81
82746 12 12 $113.77
82977 17 12 $95.39
86225 13 13 $80.89
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 22 12 $79.80
82962 56 39 $73.69
90686 24 24 $55.15
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 13 13 $49.96
90688 20 20 $22.34
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 31 25 $16.89
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 16 12 $15.14
A6260 Wound cleansers, any type, any size 46 14 $0.00
G0008 Administration of influenza virus vaccine 102 90 $0.00
G0444 Annual depression screening, 5 to 15 minutes 77 62 $0.00
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 40 33 $0.00