Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

MERCY HEALTH PHYSICIANS SPRINGFIELD SPECIALTY CARE LLC

NPI: 1790308104 · SPRINGFIELD, OH 45504 · Sports Medicine (Orthopaedic Surgery) Physician · NPI assigned 05/20/2020

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official RALSTON, KIMBERLY controls 20+ related entities in our dataset. Read more

$4.89M
Total Medicaid Paid
373,686
Total Claims
325,624
Beneficiaries
120
Codes Billed
2021-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRALSTON, KIMBERLY (SYSTEM DIRECTOR)
NPI Enumeration Date05/20/2020

Related Entities

Other providers sharing the same authorized official: RALSTON, KIMBERLY

ProviderCityStateTotal Paid
BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC RICHMOND VA $83.03M
MARYVIEW HOSPITAL LLC PORTSMOUTH VA $75.03M
BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC RICHMOND VA $57.21M
BON SECOURS ST FRANCIS MEDICAL CENTER LLC MIDLOTHIAN VA $44.86M
MERCY HEALTH YOUNGSTOWN LLC WARREN OH $43.63M
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC MECHANICSVILLE VA $42.02M
MERCY HEALTH YOUNGSTOWN LLC YOUNGSTOWN OH $36.60M
MERCY HEALTH - FAIRFIELD HOSPITAL LLC FAIRFIELD OH $25.17M
MARY IMMACULATE HOSPITAL LLC NEWPORT NEWS VA $24.51M
ST FRANCIS HOSPITAL INC GREENVILLE SC $17.81M
NWO INTEGRATED LABORATORIES MERCY LLC TOLEDO OH $13.47M
HOSPICE OF THE VALLEY, INC. GIRARD OH $13.33M
MERCY HEALTH - TIFFIN HOSPITAL LLC TIFFIN OH $12.99M
MERCY HEALTH - DEFIANCE HOSPITAL LLC DEFIANCE OH $11.90M
BON SECOURS DEPAUL MEDICAL CENTER LLC NORFOLK VA $11.59M
COMMUNITY MERCY HEALTH PARTNERS URBANA OH $8.81M
MERCY HEALTH-ALLEN HOSPITAL LLC OBERLIN OH $8.61M
CHESAPEAKE HOSPITAL LLC KILMARNOCK VA $6.00M
MARYVIEW HOSPITAL, LLC SUFFOLK VA $3.48M
ROPER ST FRANCIS ANCILLARY SERVICES LADSON SC $3.33M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 76,880 $974K
2022 102,051 $1.31M
2023 105,357 $1.37M
2024 89,398 $1.23M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 28,946 26,457 $1.23M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 27,990 24,277 $940K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 5,690 5,451 $414K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 33,862 27,873 $224K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 305 271 $151K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,455 2,292 $148K
76830 Ultrasound, transvaginal 2,319 2,227 $145K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 951 875 $113K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1,758 1,686 $101K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2,245 2,101 $93K
99233 Prolong inpt eval add15 m 3,177 1,390 $89K
99232 Subsequent hospital care, per day, moderate complexity 4,544 1,971 $85K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 1,045 1,012 $85K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 6,563 3,348 $85K
76819 Fetal biophysical profile; without non-stress testing 1,219 635 $74K
93000 6,198 5,755 $65K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1,091 970 $65K
99255 693 648 $60K
99215 Prolong outpt/office vis 911 848 $58K
99284 Emergency department visit for the evaluation and management, high severity 1,030 886 $54K
76801 808 735 $53K
59514 73 64 $43K
95911 393 387 $37K
20610 1,154 876 $37K
95886 841 818 $36K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 390 329 $28K
93015 520 474 $27K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 234 219 $24K
99205 Prolong outpt/office vis 384 310 $22K
99223 Prolong inpt eval add15 m 469 438 $22K
H1000 Prenatal care, at-risk assessment 631 550 $20K
36415 Collection of venous blood by venipuncture 6,191 5,381 $18K
99253 395 369 $17K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 66 50 $15K
99385 269 260 $14K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 633 595 $12K
59025 Fetal non-stress test 905 749 $12K
J2785 Injection, regadenoson, 0.1 mg 85 75 $11K
99254 174 164 $10K
11045 590 307 $10K
81025 1,764 1,637 $10K
90792 Psychiatric diagnostic evaluation with medical services 128 110 $9K
93296 789 745 $9K
45380 Colonoscopy, flexible; with biopsy, single or multiple 130 95 $7K
59430 77 75 $7K
77427 77 39 $6K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 515 484 $6K
99244 Office or other outpatient consultation, moderate to high complexity 78 76 $6K
93018 621 592 $5K
77014 128 14 $5K
H1002 Prenatal care, at risk enhanced service; care coordination 549 474 $4K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,083 921 $4K
93016 344 329 $4K
54150 91 86 $4K
99221 111 108 $4K
93294 250 239 $4K
93971 50 44 $3K
99245 31 30 $3K
93298 197 178 $3K
99459 241 232 $3K
90832 Psychotherapy, 30 minutes with patient 429 336 $3K
95810 Polysomnography; sleep staging with 4 or more additional parameters 46 43 $3K
94060 104 92 $3K
95910 28 27 $2K
90791 Psychiatric diagnostic evaluation 92 85 $2K
99238 Hospital discharge day management, 30 minutes or less 93 90 $2K
93970 25 25 $2K
94729 104 93 $2K
93017 81 79 $2K
95816 70 65 $2K
93297 119 111 $1K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 13 13 $1K
99231 Subsequent hospital care, per day, straightforward or low complexity 94 51 $1K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 16 14 $1K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 86 82 $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 82 70 $917.06
97597 193 116 $880.10
99222 Initial hospital care, per day, moderate complexity 38 36 $819.61
99220 13 13 $783.18
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 28 27 $671.62
93295 27 24 $620.78
93272 19 18 $397.94
73564 37 28 $394.30
99239 Hospital discharge day management, more than 30 minutes 21 19 $392.74
73562 18 14 $332.64
94618 13 13 $300.02
81002 130 122 $275.15
93227 12 12 $265.59
94727 13 13 $257.84
H1003 Prenatal care, at-risk enhanced service; education 13 13 $190.95
94726 13 12 $181.35
80305 12 12 $102.02
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 35,721 32,227 $58.98
2022F 422 393 $40.01
3017F 20,012 18,210 $18.14
3046F 88 80 $10.00
11719 43 29 $8.74
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 55,118 49,555 $1.09
1123F 2,804 2,504 $0.04
3074F 4,801 4,393 $0.03
3078F 5,531 5,015 $0.03
1036F 34,515 30,666 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 5,357 4,347 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 3,788 3,337 $0.00
G8926 Spirometry test not performed or documented, reason not given 239 225 $0.00
3075F 315 281 $0.00
3079F 637 588 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 692 654 $0.00
99024 369 227 $0.00
1126F 16 13 $0.00
99443 14 13 $0.00
G8484 Influenza immunization was not administered, reason not given 28,824 25,408 $0.00
4004F 14,257 12,767 $0.00
3023F 503 476 $0.00
3077F 576 495 $0.00
1090F 450 386 $0.00
4040F 772 699 $0.00
G8482 Influenza immunization administered or previously received 219 185 $0.00
G8399 Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed 52 37 $0.00
1159F 18 15 $0.00