Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Supplier

Ephraim Mcdowell Regional Medical Center Incorporated

Ephraim Mcdowell Regional Medical Center Incorporated was paid $59.95M by Medicaid between Jan 2018 and Dec 2024, across 338 billing codes. Its largest line is 74177, Computed tomography, abdomen and pelvis; with contrast material — 10% of everything it billed.

33Billing provider infoEPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED
DANVILLE, KY 40422
33aNPI1821135963assigned 01/30/2007
33bProvider typePharmacy
28Total paid$59.95M
24GClaims1,036,528
24DCodes billed338
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pharmacy providers in Kentucky

Rank by total paid#1 of 54
Median peer was paid$84.85
This provider vs. median706,588×

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 SNAPP, WILLIAM controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$500K$1.0M$1.5M2018201920202021202220232024
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
YearClaimsPaid
2018144,871$8.19M
2019136,996$7.99M
2020131,799$6.81M
2021152,201$8.39M
2022165,971$8.98M
2023171,312$10.49M
2024incomplete133,378$9.09M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
74177 Computed tomography, abdomen and pelvis; with contrast material 10% 7,785 5,869 $6.27M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 6.1% 20,735 16,021 $3.67M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 5.2% 21,890 18,727 $3.12M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 4.4% 26,153 22,856 $2.66M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3.9% 4,612 3,979 $2.34M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 3.1% 22,994 7,933 $1.89M
97530 Therapeutic activities, direct patient contact, each 15 minutes 3.0% 19,251 7,001 $1.77M
70450 Computed tomography, head or brain; without contrast material 2.6% 5,914 4,580 $1.54M
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 2.5% 4,180 3,849 $1.49M
74176 Computed tomography, abdomen and pelvis; without contrast material 2.5% 2,609 1,872 $1.48M
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 2.3% 15,536 5,693 $1.37M
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 2.1% 3,221 1,668 $1.29M
326 more codes
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1.8% 12,396 $1.10M
96375 Therapeutic injection; each additional sequential IV push 1.8% 15,059 $1.07M
G0378 Hospital observation service, per hour 1.6% 9,006 $938K
71275 Computed tomographic angiography, chest, with contrast material 1.5% 2,337 $928K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 1.3% 16,662 $787K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1.3% 2,925 $768K
71045 Radiologic examination, chest; single view 1.1% 17,543 $676K
47563 1.1% 442 $672K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 1.1% 3,218 $652K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 1.1% 4,492 $644K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 1.1% 16,006 $632K
80053 Comprehensive metabolic panel 1.0% 72,475 $628K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 1,622 $591K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 1,394 $583K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 10,928 $579K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 3,242 $570K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 11,358 $563K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 10,697 $553K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 454 $538K
93017 <1% 2,190 $512K
96361 Intravenous infusion, hydration; each additional hour <1% 15,052 $450K
72125 Computed tomography, cervical spine; without contrast material <1% 1,728 $443K
77067 Screening mammography, bilateral, including computer-aided detection <1% 4,244 $427K
87631 <1% 3,916 $427K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 57,368 $405K
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% 5,639 $400K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 323 $393K
71250 <1% 1,361 $389K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism <1% 13,710 $378K
36415 Collection of venous blood by venipuncture <1% 91,183 $345K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 586 $331K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 370 $318K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 4,367 $317K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 4,317 $314K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 3,529 $303K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 895 $298K
92526 <1% 3,191 $293K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 5,325 $290K
76830 Ultrasound, transvaginal <1% 1,237 $269K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) <1% 285 $250K
71046 Radiologic examination, chest; 2 views <1% 5,121 $244K
87486 <1% 8,447 $238K
76642 <1% 2,246 $234K
87581 <1% 8,193 $232K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 3,253 $196K
87507 <1% 579 $193K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 13,419 $178K
78227 <1% 439 $176K
84484 <1% 13,443 $175K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 753 $171K
96376 <1% 4,774 $168K
84443 Thyroid stimulating hormone (TSH) <1% 10,542 $163K
97162 <1% 2,882 $162K
97113 <1% 1,844 $160K
73630 <1% 2,384 $153K
59025 Fetal non-stress test <1% 3,902 $142K
70486 <1% 510 $139K
72141 <1% 378 $139K
73560 <1% 2,231 $135K
73610 <1% 1,863 $130K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 1,018 $126K
88304 <1% 2,945 $120K
93971 <1% 1,198 $116K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 503 $113K
83880 <1% 3,874 $113K
70498 <1% 334 $111K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 4,655 $105K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 3,002 $100K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 1,453 $100K
73130 <1% 1,463 $98K
96415 <1% 373 $95K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 4,810 $91K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 2,834 $91K
73030 <1% 1,367 $89K
77063 Screening digital breast tomosynthesis, bilateral <1% 5,388 $89K
74018 <1% 1,607 $87K
83690 <1% 9,346 $85K
84703 <1% 10,674 $85K
97166 <1% 1,369 $85K
80061 Lipid panel <1% 7,121 $84K
62323 <1% 225 $84K
G0463 Hospital outpatient clinic visit for assessment and management of a patient <1% 24,479 $84K
97161 <1% 1,211 $83K
96367 <1% 2,870 $82K
70496 <1% 196 $82K
83605 <1% 7,150 $82K
94060 <1% 361 $80K
76536 <1% 575 $79K
99215 Doctor's office visit, returning patient (complex) <1% 1,033 $78K
81001 <1% 21,109 $76K
87086 Culture, bacterial; quantitative colony count, urine <1% 9,415 $76K
36591 <1% 3,571 $74K
77065 Tomosynthesis, mammo <1% 915 $71K
J0131 Injection, acetaminophen, not otherwise specified,10 mg <1% 4,898 $69K
83735 <1% 10,568 $69K
80048 Basic metabolic panel (calcium, ionized) <1% 10,764 $67K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 2,351 $67K
84145 <1% 3,172 $65K
70551 Magnetic resonance imaging, brain; without contrast material <1% 160 $62K
93226 <1% 268 $59K
97116 <1% 723 $58K
82728 <1% 4,951 $56K
73110 <1% 775 $55K
93970 <1% 273 $54K
95811 <1% 73 $52K
84439 <1% 5,762 $50K
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 2,086 $50K
82607 <1% 3,918 $49K
85027 <1% 8,221 $49K
94760 <1% 3,756 $49K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 2,017 $48K
J3490 Unclassified drugs <1% 4,938 $46K
0202U Oncology (prostate), multianalyte, gene expression profiling <1% 462 $46K
80320 <1% 1,671 $45K
77066 Tomosynthesis, mammo <1% 426 $45K
99213 Doctor's office visit, returning patient (routine) <1% 911 $45K
96417 <1% 538 $45K
80074 <1% 1,196 $45K
88312 <1% 951 $44K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,257 $43K
83036 Hemoglobin; glycosylated (A1C) <1% 4,404 $43K
74300 <1% 296 $42K
96368 <1% 1,949 $42K
84702 <1% 3,031 $40K
87077 <1% 6,803 $40K
62369 <1% 343 $40K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 145 $40K
62370 <1% 280 $39K
74178 <1% 43 $39K
12001 <1% 326 $39K
87186 <1% 4,559 $37K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 920 $35K
76770 <1% 186 $35K
92610 <1% 235 $34K
J7030 Infusion, normal saline solution , 1000 cc <1% 5,355 $34K
85610 <1% 8,614 $33K
94726 <1% 175 $33K
72100 <1% 482 $33K
93924 <1% 189 $32K
87070 <1% 4,004 $31K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 3,479 $31K
83550 <1% 4,169 $31K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose <1% 262 $30K
86850 <1% 3,201 $30K
84238 <1% 1,027 $29K
87040 <1% 2,345 $29K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 305 $28K
71271 <1% 775 $28K
86140 <1% 4,589 $27K
97535 Self-care/home management training, each 15 minutes <1% 382 $27K
83540 <1% 4,609 $26K
82378 <1% 1,698 $26K
85379 <1% 2,855 $26K
84481 <1% 1,298 $26K
82803 <1% 1,213 $24K
47562 <1% 13 $24K
93225 <1% 304 $23K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis <1% 23 $22K
C9290 Injection, bupivacaine liposome, 1 mg <1% 184 $22K
87150 <1% 512 $22K
82962 <1% 6,430 $21K
82746 <1% 1,784 $21K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 573 $20K
85730 <1% 3,617 $20K
44970 <1% 22 $19K
73502 <1% 279 $19K
86300 <1% 1,038 $18K
95806 <1% 225 $18K
72110 <1% 162 $18K
88307 <1% 247 $18K
73590 <1% 250 $17K
J7120 Ringers lactate infusion, up to 1000 cc <1% 2,820 $17K
90715 <1% 822 $16K
84112 <1% 199 $16K
92523 <1% 148 $16K
80329 <1% 226 $15K
C1781 Mesh (implantable) <1% 48 $15K
77080 <1% 263 $15K
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% 264 $15K
88300 <1% 1,068 $14K
87503 <1% 633 $14K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg <1% 1,286 $13K
83615 <1% 1,568 $12K
84153 <1% 723 $12K
82565 <1% 1,200 $12K
82784 <1% 1,253 $11K
73090 <1% 160 $11K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 450 $11K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 2,326 $10K
82550 <1% 1,585 $10K
82077 <1% 477 $10K
86901 <1% 3,258 $10K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring <1% 39 $10K
86038 <1% 955 $9K
78264 <1% 41 $9K
87205 <1% 2,407 $9K
85007 <1% 2,882 $9K
86900 <1% 3,319 $9K
J2785 Injection, regadenoson, 0.1 mg <1% 99 $8K
27096 <1% 26 $8K
43248 <1% 41 $8K
J2704 Injection, propofol, 10 mg <1% 944 $8K
73080 <1% 137 $8K
85652 <1% 2,518 $7K
83921 <1% 430 $7K
A9575 Injection, gadoterate meglumine, 0.1 ml <1% 186 $7K
77062 <1% 280 $7K
43235 <1% 15 $7K
84550 <1% 1,447 $7K
86703 <1% 403 $6K
M0245 Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring <1% 18 $6K
80076 <1% 830 $6K
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 1,177 $6K
85045 <1% 1,607 $6K
87430 <1% 464 $6K
87493 <1% 404 $6K
G0379 Direct admission of patient for hospital observation care <1% 41 $5K
95819 <1% 26 $5K
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% 225 $5K
72131 <1% 16 $4K
J0690 Injection, cefazolin sodium, 500 mg <1% 721 $4K
J3010 Injection, fentanyl citrate, 0.1 mg <1% 1,245 $4K
87522 Neg quan hep c or qual rna <1% 137 $4K
97164 <1% 114 $4K
81003 <1% 1,841 $4K
87899 <1% 334 $4K
84403 <1% 136 $4K
97802 <1% 235 $3K
97014 <1% 102 $3K
84100 <1% 826 $3K
93880 <1% 32 $3K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 12 $3K
82570 <1% 656 $3K
83516 <1% 214 $3K
87046 <1% 178 $3K
82043 <1% 672 $3K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units <1% 336 $3K
77061 <1% 118 $2K
82553 <1% 276 $2K
A9510 Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries <1% 28 $2K
82150 <1% 346 $2K
J2274 Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg <1% 631 $2K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 23 $2K
74022 <1% 28 $2K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml <1% 46 $2K
86706 <1% 251 $2K
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation <1% 26 $2K
97010 <1% 67 $2K
87045 <1% 174 $2K
J1756 Injection, iron sucrose, 1 mg <1% 25 $2K
86364 <1% 150 $2K
76870 <1% 14 $2K
80050 General health panel <1% 187 $1K
93975 <1% 14 $1K
99406 <1% 114 $1K
J2919 Injection, methylprednisolone sodium succinate, 5 mg <1% 190 $1K
72072 <1% 14 $1K
86258 <1% 72 $1K
85576 <1% 31 $1K
86431 <1% 177 $1K
99214 Doctor's office visit, returning patient (more involved) <1% 29 $1K
87147 <1% 148 $1K
86334 <1% 59 $1K
95886 <1% 21 $978.30
83521 <1% 56 $926.17
97163 <1% 12 $903.13
96523 <1% 40 $877.21
29125 <1% 16 $851.65
73140 <1% 14 $828.60
87641 <1% 36 $767.23
72040 <1% 16 $754.82
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 100 $726.46
80069 <1% 131 $704.32
87328 <1% 60 $702.50
36416 <1% 119 $623.67
87329 <1% 47 $576.57
A4648 Tissue marker, implantable, any type, each <1% 19 $575.70
J1790 Injection, droperidol, up to 5 mg <1% 88 $556.82
82010 <1% 71 $549.98
J2270 Injection, morphine sulfate, up to 10 mg <1% 95 $538.28
51701 <1% 25 $513.09
86231 <1% 59 $511.38
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 17 $501.82
84165 <1% 59 $499.38
88173 <1% 14 $475.74
83993 <1% 36 $466.81
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 117 $432.44
84480 <1% 52 $422.65
87210 <1% 105 $405.47
11721 <1% 88 $379.05
85014 <1% 245 $364.29
84207 <1% 14 $358.27
83525 <1% 25 $322.98
86376 <1% 15 $299.75
83883 <1% 36 $294.21
87340 <1% 52 $280.56
J1170 Injection, hydromorphone, up to 4 mg <1% 67 $276.17
82652 <1% 14 $269.50
90686 <1% 24 $264.98
82542 <1% 12 $253.15
85018 <1% 137 $225.85
87625 <1% 12 $211.09
82248 <1% 48 $202.63
82533 <1% 16 $193.98
84425 <1% 14 $181.50
86592 <1% 43 $172.23
86308 <1% 27 $166.85
86803 <1% 12 $166.43
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc <1% 23 $153.67
J1171 Injection, hydromorphone, 0.1 mg <1% 77 $144.45
J3370 Injection, vancomycin hcl, 500 mg <1% 22 $142.33
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 13 $136.01
J1596 Injection, glycopyrrolate, 0.1 mg <1% 14 $133.96
A4663 Blood pressure cuff only <1% 68 $121.25
J0330 Injection, succinylcholine chloride, up to 20 mg <1% 17 $116.18
84132 <1% 31 $113.84
A9270 Non-covered item or service <1% 56 $85.99
J1030 Injection, methylprednisolone acetate, 40 mg <1% 17 $75.27
87075 <1% 18 $74.33
J2470 Injection, pantoprazole sodium, 40 mg <1% 52 $72.27
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 13 $56.59
J2060 Injection, lorazepam, 2 mg <1% 15 $47.61
J9055 Injection, cetuximab, 10 mg <1% 17 $36.90
84156 <1% 13 $32.09
Q0244 Injection, casirivimab and imdevimab, 1200 mg <1% 27 $0.02
Q0245 Injection, bamlanivimab and etesevimab, 2100 mg 0% 32 $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.

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Authorized officialSNAPP, WILLIAM (CFO)
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