NPI: 1841278637 · SPARTA, WI 54656 · Critical Access Hospital · NPI assigned 01/03/2006
Authorized official BORTNEM, MARK controls 20+ related entities in our dataset. Read more
| Authorized Official | BORTNEM, MARK (CHIEF FINANCIAL OFFICER) |
| Parent Organization | MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. |
| NPI Enumeration Date | 01/03/2006 |
Other providers sharing the same authorized official: BORTNEM, MARK
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 11,278 | $851K |
| 2019 | 11,616 | $846K |
| 2020 | 10,390 | $754K |
| 2021 | 16,583 | $1.25M |
| 2022 | 19,998 | $1.56M |
| 2023 | 18,759 | $1.89M |
| 2024 | 14,993 | $1.27M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 11,316 | 9,459 | $2.73M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 6,766 | 5,138 | $1.33M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 5,648 | 4,210 | $1.17M |
| 96361 | Intravenous infusion, hydration; each additional hour | 1,902 | 1,601 | $1.08M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 3,508 | 3,134 | $645K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 870 | 770 | $312K |
| 70450 | Computed tomography, head or brain; without contrast material | 765 | 685 | $242K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 3,466 | 1,489 | $109K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 192 | 150 | $60K |
| 80053 | Comprehensive metabolic panel | 5,890 | 5,097 | $55K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1,790 | 1,631 | $52K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1,113 | 1,025 | $50K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1,448 | 1,356 | $47K |
| 87631 | 436 | 400 | $45K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 8,380 | 7,049 | $45K |
| 71046 | Radiologic examination, chest; 2 views | 2,223 | 1,985 | $42K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,236 | 2,016 | $41K |
| 84443 | Thyroid stimulating hormone (TSH) | 2,857 | 2,676 | $40K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 280 | 239 | $36K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 436 | 395 | $26K |
| 80048 | Basic metabolic panel (calcium, ionized) | 3,187 | 2,839 | $25K |
| 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 | 398 | 363 | $23K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 57 | 51 | $20K |
| 84484 | 1,804 | 1,568 | $17K | |
| 80061 | Lipid panel | 1,073 | 1,020 | $13K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 510 | 229 | $12K |
| 81025 | 1,452 | 1,293 | $11K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 2,758 | 2,278 | $10K |
| 83036 | Hemoglobin; glycosylated (A1C) | 1,151 | 1,096 | $8K |
| 81001 | 3,057 | 2,725 | $8K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 3,496 | 2,945 | $7K |
| 83690 | 1,409 | 1,237 | $7K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 138 | 110 | $6K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 372 | 341 | $6K |
| 80306 | 451 | 398 | $6K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 219 | 94 | $6K |
| 97162 | 159 | 146 | $6K | |
| 71275 | Computed tomographic angiography, chest, with contrast material | 12 | 12 | $6K |
| 83880 | 290 | 261 | $5K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 16 | 13 | $5K |
| 85610 | 1,536 | 1,079 | $5K | |
| 83605 | 676 | 601 | $5K | |
| 82077 | 258 | 225 | $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 | 299 | 270 | $5K |
| 85379 | 621 | 560 | $4K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 698 | 636 | $4K |
| 81003 | 1,522 | 1,358 | $3K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 37 | 37 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1,889 | 1,568 | $3K |
| 83735 | 621 | 540 | $3K | |
| 73630 | 115 | 92 | $2K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 78 | 49 | $2K |
| 86140 | 416 | 378 | $2K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | 12 | 12 | $1K |
| 71045 | Radiologic examination, chest; single view | 1,062 | 959 | $1K |
| 82947 | 393 | 308 | $1K | |
| 73610 | 68 | 60 | $1K | |
| 85027 | 223 | 203 | $952.02 | |
| 82570 | 162 | 158 | $744.18 | |
| 36415 | Collection of venous blood by venipuncture | 3,085 | 2,523 | $690.96 |
| 84702 | 48 | 41 | $668.04 | |
| 96375 | Therapeutic injection; each additional sequential IV push | 1,572 | 1,336 | $647.76 |
| 82043 | 111 | 108 | $598.28 | |
| 82248 | 203 | 180 | $587.50 | |
| 80050 | General health panel | 20 | 18 | $402.75 |
| 87103 | 25 | 25 | $364.13 | |
| 97161 | 14 | 12 | $354.83 | |
| 87040 | 49 | 26 | $284.34 | |
| 80143 | 26 | 24 | $258.27 | |
| 82948 | 62 | 37 | $228.70 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 1,799 | 1,532 | $166.49 |
| 80179 | 14 | 12 | $135.99 | |
| 87077 | 13 | 13 | $78.66 | |
| 87186 | 13 | 13 | $74.76 | |
| 86850 | 14 | 14 | $62.86 | |
| 73110 | 12 | 12 | $53.47 | |
| 86900 | 12 | 12 | $37.42 | |
| 86901 | 12 | 12 | $37.42 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 638 | 546 | $27.79 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 551 | 447 | $26.86 |
| 0764T | 28 | 28 | $17.62 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 19 | 16 | $10.93 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 248 | 136 | $6.86 |
| J7050 | Infusion, normal saline solution, 250 cc | 111 | 78 | $6.33 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 34 | 33 | $4.42 |
| J8499 | Prescription drug, oral, non chemotherapeutic, nos | 41 | 29 | $0.00 |
| A9270 | Non-covered item or service | 507 | 437 | $0.00 |
| Q0162 | Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | 14 | 14 | $0.00 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 91 | 64 | $0.00 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 14 | 13 | $0.00 |