Hospital
ST Clare Memorial Hospital, INC
ST Clare Memorial Hospital, INC was paid $9.09M by Medicaid between Jan 2018 and Dec 2024, across 110 billing codes. Its largest line is 41899, Unlisted procedure, dentoalveolar structures — 22% of everything it billed.
33Billing provider infoST CLARE MEMORIAL HOSPITAL, INC
OCONTO FALLS, WI 54154
OCONTO FALLS, WI 54154
33aNPI1851477913assigned 10/31/2006
33bProvider typeCritical Access Hospital
28Total paid$9.09M
24GClaims147,680
24DCodes billed110
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Critical Access Hospital providers in Wisconsin
Rank by total paid#11 of 48
Median peer was paid$4.30M
This provider vs. median2.1×
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 ALLEN, PATRICIA controls 18+ 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 | 17,166 | $590K | |
| 2019 | 17,320 | $744K | |
| 2020 | 19,037 | $970K | |
| 2021 | 25,869 | $1.56M | |
| 2022 | 25,878 | $1.60M | |
| 2023 | 25,687 | $1.85M | |
| 2024incomplete | 16,723 | $1.77M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 41899 | Unlisted procedure, dentoalveolar structures | 22% | 1,155 | 983 | $1.99M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 14% | 6,056 | 4,616 | $1.27M |
| 96361 | Intravenous infusion, hydration; each additional hour | 12% | 2,641 | 1,868 | $1.09M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 11% | 6,502 | 4,467 | $986K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 7.6% | 2,644 | 1,100 | $687K |
| 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 | 6.9% | 10,917 | 8,729 | $623K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 6.7% | 3,922 | 2,531 | $608K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2.9% | 949 | 744 | $260K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 2.8% | 1,617 | 1,261 | $257K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.7% | 7,156 | 6,376 | $249K |
| 70450 | Computed tomography, head or brain; without contrast material | 2.5% | 906 | 694 | $225K |
| 80053 | Comprehensive metabolic panel | 2.0% | 8,298 | 5,973 | $186K |
98 more codes
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 2,490 | $48K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 9,913 | $45K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 162 | $44K |
| 80306 | <1% | 2,585 | $41K | |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 223 | $40K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 961 | $30K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,650 | $29K |
| 97597 | <1% | 202 | $27K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 762 | $25K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,291 | $21K |
| 80061 | Lipid panel | <1% | 1,564 | $19K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,089 | $19K |
| 84484 | <1% | 3,321 | $18K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 51 | $15K |
| 80050 | General health panel | <1% | 1,344 | $14K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,440 | $12K |
| 81025 | <1% | 1,383 | $12K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 323 | $11K |
| 81001 | <1% | 5,204 | $11K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 2,136 | $11K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,031 | $11K |
| 00170 | Anesthesia for intraoral procedures, including biopsy | <1% | 54 | $9K |
| 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% | 188 | $9K |
| 83690 | <1% | 1,928 | $8K | |
| 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% | 200 | $7K |
| 87081 | <1% | 620 | $7K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 29 | $7K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 426 | $7K |
| 85610 | <1% | 2,059 | $6K | |
| G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | <1% | 22 | $6K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 3,836 | $6K |
| 83735 | <1% | 1,502 | $5K | |
| 83880 | <1% | 340 | $5K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,215 | $5K |
| 83605 | <1% | 1,129 | $5K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 211 | $4K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 166 | $4K |
| 87486 | <1% | 223 | $4K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 3,850 | $4K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 126 | $4K |
| 87581 | <1% | 222 | $4K | |
| 86140 | <1% | 1,117 | $4K | |
| 71045 | Radiologic examination, chest; single view | <1% | 2,043 | $3K |
| 87040 | <1% | 1,122 | $3K | |
| 85379 | <1% | 629 | $3K | |
| 87077 | <1% | 722 | $3K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 414 | $2K |
| 99442 | <1% | 154 | $2K | |
| 90686 | <1% | 162 | $2K | |
| 87186 | <1% | 541 | $2K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 3,486 | $2K |
| 84439 | <1% | 213 | $1K | |
| 73630 | <1% | 44 | $1K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 59 | $1K |
| 85652 | <1% | 659 | $1K | |
| 0004A | <1% | 27 | $967.36 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 13 | $922.25 |
| 74018 | <1% | 16 | $828.37 | |
| 0001A | <1% | 18 | $697.57 | |
| 73030 | <1% | 17 | $618.94 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,879 | $610.05 |
| 82550 | <1% | 112 | $458.41 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 13 | $434.64 |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 13 | $434.64 |
| 0012A | <1% | 15 | $423.96 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 284 | $413.95 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 4,881 | $376.84 |
| 87088 | <1% | 91 | $357.24 | |
| 85730 | <1% | 152 | $272.40 | |
| 87420 | <1% | 19 | $263.58 | |
| J3490 | Unclassified drugs | <1% | 2,537 | $230.34 |
| 81003 | <1% | 76 | $211.94 | |
| 86803 | <1% | 14 | $202.36 | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 13 | $200.91 |
| 99307 | <1% | 15 | $171.96 | |
| 82043 | <1% | 17 | $129.06 | |
| 82962 | <1% | 139 | $126.50 | |
| 87070 | <1% | 21 | $94.37 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,876 | $85.88 |
| 82570 | <1% | 16 | $80.86 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 3,071 | $78.36 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 3,419 | $50.14 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 1,422 | $48.55 |
| J2704 | Injection, propofol, 10 mg | <1% | 1,624 | $46.79 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 138 | $25.90 |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 115 | $4.75 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,093 | $0.84 |
| J7050 | Infusion, normal saline solution, 250 cc | 0% | 31 | $0.00 |
| 96376 | 0% | 173 | $0.00 | |
| A9270 | Non-covered item or service | 0% | 434 | $0.00 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 0% | 22 | $0.00 |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 0% | 32 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 81 | $0.00 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 23 | $0.00 |
| J2004 | Injection, lidocaine hcl with epinephrine, 1 mg | 0% | 40 | $0.00 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 51 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 18 | $0.00 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 0% | 20 | $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 officialALLEN, PATRICIA (CFO)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.