Physician
Mercy Health Physicians Springfield Specialty Care LLC
Mercy Health Physicians Springfield Specialty Care LLC was paid $4.89M by Medicaid between Jan 2021 and Dec 2024, across 120 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 25% of everything it billed.
33Billing provider infoMERCY HEALTH PHYSICIANS SPRINGFIELD SPECIALTY CARE LLC
SPRINGFIELD, OH 45504
SPRINGFIELD, OH 45504
33aNPI1790308104assigned 05/20/2020
33bProvider typeSports Medicine (Orthopaedic Surgery) Physician
28Total paid$4.89M
24GClaims373,686
24DCodes billed120
24AFirst – last monthJan 2021 – Dec 2024
Compared with peers
Next to other Sports Medicine (Orthopaedic Surgery) Physician providers in Ohio
Rank by total paid#2 of 8
Median peer was paid$4K
This provider vs. median1,187×
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 RALSTON, KIMBERLY controls 20+ 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 | |
|---|---|---|---|
| 2021 | 76,880 | $974K | |
| 2022 | 102,051 | $1.31M | |
| 2023 | 105,357 | $1.37M | |
| 2024incomplete | 89,398 | $1.23M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 25% | 28,946 | 26,457 | $1.23M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 27,990 | 24,277 | $940K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 8.5% | 5,690 | 5,451 | $414K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 4.6% | 33,862 | 27,873 | $224K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 3.1% | 305 | 271 | $151K |
| 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 | 3.0% | 2,455 | 2,292 | $148K |
| 76830 | Ultrasound, transvaginal | 3.0% | 2,319 | 2,227 | $145K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 2.3% | 951 | 875 | $113K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.1% | 1,758 | 1,686 | $101K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.9% | 2,245 | 2,101 | $93K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.8% | 3,177 | 1,390 | $89K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.7% | 4,544 | 1,971 | $85K |
108 more codes
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 1.7% | 1,045 | $85K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1.7% | 6,563 | $85K |
| 76819 | Fetal biophysical profile; without non-stress testing | 1.5% | 1,219 | $74K |
| 93000 | 1.3% | 6,198 | $65K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 1.3% | 1,091 | $65K |
| 99255 | 1.2% | 693 | $60K | |
| 99215 | Doctor's office visit, returning patient (complex) | 1.2% | 911 | $58K |
| 99284 | Emergency room visit (serious) | 1.1% | 1,030 | $54K |
| 76801 | 1.1% | 808 | $53K | |
| 59514 | <1% | 73 | $43K | |
| 95911 | <1% | 393 | $37K | |
| 20610 | <1% | 1,154 | $37K | |
| 95886 | <1% | 841 | $36K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 390 | $28K |
| 93015 | <1% | 520 | $27K | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | <1% | 234 | $24K |
| 99205 | Prolong outpt/office vis | <1% | 384 | $22K |
| 99223 | Prolong inpt eval add15 m | <1% | 469 | $22K |
| H1000 | Prenatal care, at-risk assessment | <1% | 631 | $20K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,191 | $18K |
| 99253 | <1% | 395 | $17K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 66 | $15K |
| 99385 | <1% | 269 | $14K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 633 | $12K |
| 59025 | Fetal non-stress test | <1% | 905 | $12K |
| J2785 | Injection, regadenoson, 0.1 mg | <1% | 85 | $11K |
| 99254 | <1% | 174 | $10K | |
| 11045 | <1% | 590 | $10K | |
| 81025 | <1% | 1,764 | $10K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 128 | $9K |
| 93296 | <1% | 789 | $9K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 130 | $7K |
| 59430 | <1% | 77 | $7K | |
| 77427 | <1% | 77 | $6K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 515 | $6K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 78 | $6K |
| 93018 | <1% | 621 | $5K | |
| 77014 | <1% | 128 | $5K | |
| H1002 | Prenatal care, at risk enhanced service; care coordination | <1% | 549 | $4K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 1,083 | $4K |
| 93016 | <1% | 344 | $4K | |
| 54150 | <1% | 91 | $4K | |
| 99221 | <1% | 111 | $4K | |
| 93294 | <1% | 250 | $4K | |
| 93971 | <1% | 50 | $3K | |
| 99245 | <1% | 31 | $3K | |
| 93298 | <1% | 197 | $3K | |
| 99459 | <1% | 241 | $3K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 429 | $3K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 46 | $3K |
| 94060 | <1% | 104 | $3K | |
| 95910 | <1% | 28 | $2K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 92 | $2K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 93 | $2K |
| 93970 | <1% | 25 | $2K | |
| 94729 | <1% | 104 | $2K | |
| 93017 | <1% | 81 | $2K | |
| 95816 | <1% | 70 | $2K | |
| 93297 | <1% | 119 | $1K | |
| 99285 | Emergency room visit (most serious) | <1% | 13 | $1K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 94 | $1K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 16 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 86 | $1K |
| G2066 | Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results | <1% | 82 | $917.06 |
| 97597 | <1% | 193 | $880.10 | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 38 | $819.61 |
| 99220 | <1% | 13 | $783.18 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 28 | $671.62 |
| 93295 | <1% | 27 | $620.78 | |
| 93272 | <1% | 19 | $397.94 | |
| 73564 | <1% | 37 | $394.30 | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 21 | $392.74 |
| 73562 | <1% | 18 | $332.64 | |
| 94618 | <1% | 13 | $300.02 | |
| 81002 | <1% | 130 | $275.15 | |
| 93227 | <1% | 12 | $265.59 | |
| 94727 | <1% | 13 | $257.84 | |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 13 | $190.95 |
| 94726 | <1% | 13 | $181.35 | |
| 80305 | <1% | 12 | $102.02 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | <1% | 35,721 | $58.98 |
| 2022F | <1% | 422 | $40.01 | |
| 3017F | <1% | 20,012 | $18.14 | |
| 3046F | <1% | 88 | $10.00 | |
| 11719 | <1% | 43 | $8.74 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 55,118 | $1.09 |
| 1123F | <1% | 2,804 | $0.04 | |
| 3074F | <1% | 4,801 | $0.03 | |
| 3078F | <1% | 5,531 | $0.03 | |
| 1036F | 0% | 34,515 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 5,357 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 3,788 | $0.00 |
| G8926 | Spirometry test not performed or documented, reason not given | 0% | 239 | $0.00 |
| 3075F | 0% | 315 | $0.00 | |
| 3079F | 0% | 637 | $0.00 | |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 692 | $0.00 |
| 99024 | 0% | 369 | $0.00 | |
| 1126F | 0% | 16 | $0.00 | |
| 99443 | 0% | 14 | $0.00 | |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 28,824 | $0.00 |
| 4004F | 0% | 14,257 | $0.00 | |
| 3023F | 0% | 503 | $0.00 | |
| 3077F | 0% | 576 | $0.00 | |
| 1090F | 0% | 450 | $0.00 | |
| 4040F | 0% | 772 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 219 | $0.00 |
| G8399 | Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed | 0% | 52 | $0.00 |
| 1159F | 0% | 18 | $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 officialRALSTON, KIMBERLY (SYSTEM DIRECTOR)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.