Physician
Rochester General Hospital
Rochester General Hospital was paid $11.31M by Medicaid between Jan 2018 and Dec 2024, across 54 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.
33Billing provider infoROCHESTER GENERAL HOSPITAL
SODUS, NY 14551
SODUS, NY 14551
33aNPI1821163718assigned 11/24/2006
33bProvider typeGastroenterology Physician
28Total paid$11.31M
24GClaims195,895
24DCodes billed54
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Gastroenterology Physician providers in New York
Rank by total paid#1 of 656
Median peer was paid$12K
This provider vs. median930×
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 TINCH, PAULA 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 | |
|---|---|---|---|
| 2018 | 19,753 | $1.11M | |
| 2019 | 22,461 | $1.32M | |
| 2020 | 27,416 | $1.57M | |
| 2021 | 33,984 | $1.89M | |
| 2022 | 36,734 | $2.05M | |
| 2023 | 35,784 | $2.16M | |
| 2024incomplete | 19,763 | $1.21M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 40% | 73,975 | 69,440 | $4.58M |
| 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 | 27% | 33,690 | 32,407 | $3.03M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.1% | 7,843 | 7,839 | $687K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.9% | 7,519 | 7,517 | $665K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 5.7% | 16,963 | 16,429 | $645K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.2% | 5,921 | 5,544 | $478K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.6% | 4,212 | 4,210 | $404K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 2,749 | 2,453 | $106K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 5,563 | 5,551 | $102K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,689 | 6,676 | $77K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 6,557 | 6,443 | $63K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 772 | 772 | $59K |
42 more codes
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 573 | $51K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 395 | $51K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 788 | $28K |
| 96127 | <1% | 4,832 | $25K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 348 | $24K |
| 76801 | <1% | 534 | $22K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,423 | $20K |
| 99051 | <1% | 2,153 | $20K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 219 | $18K |
| 59025 | Fetal non-stress test | <1% | 665 | $17K |
| 99080 | <1% | 355 | $16K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 302 | $15K |
| 99173 | <1% | 5,958 | $14K | |
| J3490 | Unclassified drugs | <1% | 243 | $13K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 103 | $11K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 53 | $10K |
| 92551 | <1% | 1,169 | $8K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 161 | $7K |
| 90682 | <1% | 89 | $5K | |
| 99152 | <1% | 477 | $5K | |
| 99188 | <1% | 320 | $5K | |
| 81025 | <1% | 721 | $4K | |
| 99442 | <1% | 97 | $4K | |
| 76813 | <1% | 75 | $4K | |
| 90686 | <1% | 166 | $3K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 62 | $3K |
| 69210 | <1% | 62 | $2K | |
| 90688 | <1% | 135 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 202 | $2K |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | <1% | 15 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 13 | $2K |
| 83655 | <1% | 111 | $1K | |
| 99417 | Prolong home eval add 15m | <1% | 31 | $1K |
| 43249 | <1% | 12 | $1K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 147 | $1K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 109 | $609.71 |
| 90715 | <1% | 12 | $473.16 | |
| 85018 | <1% | 144 | $325.08 | |
| 99441 | <1% | 26 | $320.95 | |
| 96160 | <1% | 57 | $151.82 | |
| 96161 | <1% | 57 | $142.52 | |
| 99177 | <1% | 28 | $101.36 |
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 officialTINCH, PAULA (SVP-FINANCE)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.