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

Upmc Mercy

Upmc Mercy was paid $16.68M by Medicaid between Oct 2018 and Dec 2024, across 324 billing codes. Its largest line is 99284, emergency room visit (serious) — 36% of everything it billed.

33Billing provider infoUPMC MERCY
PITTSBURGH, PA 15219
33aNPI1881695146assigned 08/09/2005
33bProvider typeClinic/Center
28Total paid$16.68M
24GClaims541,308
24DCodes billed324
24AFirst – last monthOct 2018 – Dec 2024
Compared with peers

Next to other Clinic/Center providers in Pennsylvania

Rank by total paid#11 of 176
Median peer was paid$441K
This provider vs. median38×

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.

Box 24A · Dates of service

Paid by month

$0$250K$500K$750K2018201920202021202220232024
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
201829$278.45
2019415$8K
202053,160$1.32M
2021232,335$6.91M
202291,627$2.90M
202393,297$3.05M
2024incomplete70,445$2.50M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 36% 37,026 35,543 $6.02M
G0378 Hospital observation service, per hour 14% 8,389 3,183 $2.26M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 12% 19,757 18,790 $2.03M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 12% 11,559 11,092 $2.00M
T1015 A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive 2.4% 14,401 12,983 $398K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 2.0% 18,156 17,290 $327K
74177 Computed tomography, abdomen and pelvis; with contrast material 1.7% 2,391 2,338 $279K
70450 Computed tomography, head or brain; without contrast material 1.2% 4,307 4,144 $204K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 1.1% 209 195 $180K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 3,783 3,406 $165K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 41,293 34,704 $140K
80053 Comprehensive metabolic panel <1% 17,891 16,422 $130K
312 more codes
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 18,287 $117K
80048 Basic metabolic panel (calcium, ionized) <1% 20,007 $96K
96375 Therapeutic injection; each additional sequential IV push <1% 7,955 $89K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 1,586 $83K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 319 $81K
72125 Computed tomography, cervical spine; without contrast material <1% 1,421 $70K
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% 1,204 $69K
71045 Radiologic examination, chest; single view <1% 13,108 $66K
71275 Computed tomographic angiography, chest, with contrast material <1% 506 $65K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 331 $64K
73221 <1% 261 $59K
70551 Magnetic resonance imaging, brain; without contrast material <1% 348 $57K
84484 <1% 9,082 $55K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 383 $49K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring <1% 140 $49K
J0475 Injection, baclofen, 10 mg <1% 538 $46K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 742 $38K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 597 $36K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 466 $34K
73610 <1% 2,329 $34K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 600 $34K
73630 <1% 3,819 $34K
72141 <1% 187 $34K
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% 271 $33K
J3490 Unclassified drugs <1% 13,629 $32K
70498 <1% 239 $30K
83735 <1% 9,229 $29K
16020 <1% 1,423 $28K
70496 <1% 215 $28K
70486 <1% 509 $27K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 576 $26K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 213 $26K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 119 $22K
Q3014 Telehealth originating site facility fee <1% 1,397 $22K
80050 General health panel <1% 574 $20K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 670 $20K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 336 $19K
73030 <1% 1,448 $18K
84100 <1% 6,802 $18K
76801 <1% 435 $17K
93975 <1% 192 $17K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 54 $16K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 2,160 $16K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 978 $15K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 525 $15K
83690 <1% 4,835 $15K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 459 $15K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 982 $15K
93971 <1% 296 $14K
71250 <1% 317 $14K
84443 Thyroid stimulating hormone (TSH) <1% 988 $14K
73564 <1% 793 $13K
80061 Lipid panel <1% 1,396 $13K
84703 <1% 1,824 $12K
81025 <1% 4,751 $12K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 133 $12K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 10,099 $12K
71046 Radiologic examination, chest; 2 views <1% 1,040 $11K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 588 $11K
J1815 Injection, insulin, per 5 units <1% 1,442 $11K
90715 <1% 1,690 $10K
85730 <1% 2,668 $10K
96367 <1% 525 $10K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 571 $10K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 470 $10K
85610 <1% 4,676 $10K
74183 <1% 24 $10K
80076 <1% 1,793 $9K
82803 <1% 401 $9K
83036 Hemoglobin; glycosylated (A1C) <1% 1,995 $8K
72100 <1% 437 $8K
J7120 Ringers lactate infusion, up to 1000 cc <1% 26,044 $8K
83605 <1% 1,633 $8K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 51 $8K
76830 Ultrasound, transvaginal <1% 193 $8K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 837 $8K
J2785 Injection, regadenoson, 0.1 mg <1% 153 $7K
81003 <1% 3,585 $7K
93017 <1% 266 $7K
83880 <1% 383 $7K
73502 <1% 434 $7K
73562 <1% 472 $7K
82962 <1% 5,332 $6K
11721 <1% 759 $6K
73590 <1% 531 $6K
76536 <1% 156 $6K
73700 <1% 113 $6K
73560 <1% 392 $6K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 231 $6K
87040 <1% 590 $6K
87086 Culture, bacterial; quantitative colony count, urine <1% 1,132 $6K
76775 <1% 173 $6K
J3535 Drug administered through a metered dose inhaler <1% 1,227 $6K
73130 <1% 672 $6K
62370 <1% 262 $6K
96361 Intravenous infusion, hydration; each additional hour <1% 523 $5K
81002 <1% 2,338 $5K
85027 <1% 1,575 $5K
80305 <1% 821 $5K
82728 <1% 551 $5K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes <1% 152 $5K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 105 $5K
43235 <1% 25 $5K
80329 <1% 462 $4K
86850 <1% 985 $4K
A9577 Injection, gadobenate dimeglumine (multihance), per ml <1% 742 $4K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 271 $4K
87905 <1% 467 $4K
43248 <1% 12 $4K
82607 <1% 514 $4K
85379 <1% 560 $4K
93970 <1% 71 $4K
J1170 Injection, hydromorphone, up to 4 mg <1% 9,657 $4K
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) <1% 233 $4K
G0008 Administration of influenza virus vaccine <1% 477 $4K
73110 <1% 445 $4K
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% 63 $3K
64642 <1% 80 $3K
87808 <1% 462 $3K
82565 <1% 1,213 $3K
73552 <1% 266 $3K
84439 <1% 675 $3K
94729 <1% 139 $3K
86702 <1% 322 $3K
70544 <1% 17 $3K
84153 <1% 150 $3K
83540 <1% 504 $3K
81001 <1% 1,533 $3K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 39 $3K
86701 <1% 322 $3K
82550 <1% 567 $3K
G0463 Hospital outpatient clinic visit for assessment and management of a patient <1% 377 $3K
J3473 Injection, hyaluronidase, recombinant, 1 usp unit <1% 572 $2K
J8501 Aprepitant, oral, 5 mg <1% 362 $2K
87186 <1% 487 $2K
87390 <1% 321 $2K
72131 <1% 48 $2K
82784 <1% 90 $2K
94726 <1% 119 $2K
86901 <1% 989 $2K
74178 <1% 12 $2K
86900 <1% 988 $2K
87205 <1% 828 $2K
74018 <1% 230 $2K
J0171 Injection, adrenalin, epinephrine, 0.1 mg <1% 712 $2K
82043 <1% 351 $2K
82330 <1% 404 $2K
82746 <1% 240 $2K
72170 <1% 290 $2K
87077 <1% 399 $2K
J7030 Infusion, normal saline solution , 1000 cc <1% 2,931 $2K
84702 <1% 150 $2K
J3370 Injection, vancomycin hcl, 500 mg <1% 1,165 $2K
85576 <1% 127 $2K
85652 <1% 822 $2K
83550 <1% 491 $2K
86140 <1% 821 $2K
86706 <1% 142 $2K
82977 <1% 200 $2K
87075 <1% 328 $1K
72040 <1% 111 $1K
P9045 Infusion, albumin (human), 5%, 250 ml <1% 198 $1K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 42 $1K
73090 <1% 183 $1K
J0690 Injection, cefazolin sodium, 500 mg <1% 3,630 $1K
87070 <1% 426 $1K
87340 <1% 113 $1K
73060 <1% 167 $1K
73080 <1% 172 $1K
93923 <1% 26 $1K
J0780 Injection, prochlorperazine, up to 10 mg <1% 2,104 $1K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 10,370 $1K
87522 Neg quan hep c or qual rna <1% 31 $1K
36430 <1% 14 $1K
97162 <1% 311 $1K
C9399 Unclassified drugs or biologicals <1% 186 $1K
86803 <1% 76 $1K
86704 <1% 82 $958.93
86780 <1% 79 $948.53
88342 <1% 60 $944.97
94060 <1% 135 $881.11
J1644 Injection, heparin sodium, per 1000 units <1% 2,561 $870.30
84520 <1% 308 $869.04
J3010 Injection, fentanyl citrate, 0.1 mg <1% 7,334 $867.07
97161 <1% 191 $831.23
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 4,626 $824.81
J1650 Injection, enoxaparin sodium, 10 mg <1% 3,201 $813.79
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 16 $805.40
82105 <1% 42 $763.91
76937 <1% 211 $742.52
J1030 Injection, methylprednisolone acetate, 40 mg <1% 162 $723.76
88112 <1% 41 $716.95
76870 <1% 25 $715.75
85007 <1% 322 $691.48
82947 <1% 375 $691.07
95991 <1% 107 $684.02
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 14,344 $650.58
70491 <1% 12 $639.38
84134 <1% 62 $619.02
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 518 $577.06
U0001 Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel <1% 20 $575.43
90682 <1% 129 $569.38
86038 <1% 55 $567.15
80177 <1% 57 $553.94
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 20 $521.85
85014 <1% 343 $514.60
83970 <1% 16 $513.27
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 2,212 $496.39
77002 <1% 12 $484.07
11056 <1% 13 $478.07
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 132 $471.12
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 414 $456.20
0001A <1% 18 $452.00
76942 <1% 143 $432.06
S0020 Injection, bupivicaine hydrochloride, 30 ml <1% 961 $419.06
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 12 $409.11
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm <1% 560 $390.00
86592 <1% 124 $371.96
83615 <1% 88 $364.39
82378 <1% 47 $357.48
J2795 Injection, ropivacaine hydrochloride, 1 mg <1% 214 $356.00
29581 <1% 43 $329.56
72110 <1% 14 $328.92
73070 <1% 33 $325.30
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 2,582 $311.01
80051 <1% 95 $288.22
84132 <1% 109 $283.28
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg <1% 1,443 $276.43
73140 <1% 44 $272.07
99153 Mod sedat endo service >5yrs <1% 143 $264.02
87147 <1% 74 $258.83
J7999 Compounded drug, not otherwise classified <1% 3,953 $257.93
90674 <1% 73 $250.78
J2060 Injection, lorazepam, 2 mg <1% 2,107 $246.05
J1630 Injection, haloperidol, up to 5 mg <1% 933 $242.64
85018 <1% 152 $235.05
84165 <1% 25 $233.96
96376 <1% 549 $224.85
93308 <1% 12 $212.85
V2632 Posterior chamber intraocular lens <1% 65 $212.04
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 6,077 $207.73
74220 <1% 20 $207.07
87081 <1% 82 $192.70
J7050 Infusion, normal saline solution, 250 cc <1% 2,633 $186.06
S0028 Injection, famotidine, 20 mg <1% 937 $183.30
36415 Collection of venous blood by venipuncture <1% 3,453 $182.98
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) <1% 423 $173.98
J2270 Injection, morphine sulfate, up to 10 mg <1% 250 $169.75
L1830 Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf <1% 14 $160.64
J3475 Injection, magnesium sulfate, per 500 mg <1% 730 $155.26
84295 <1% 54 $154.71
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 160 $152.72
73600 <1% 25 $147.47
88304 <1% 184 $144.95
82570 <1% 29 $143.58
J3470 Injection, hyaluronidase, up to 150 units <1% 45 $141.84
J2704 Injection, propofol, 10 mg <1% 3,491 $140.24
86705 <1% 12 $137.91
87088 <1% 28 $126.06
94761 <1% 203 $113.70
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose <1% 13 $94.38
J1953 Injection, levetiracetam, 10 mg <1% 108 $93.00
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 389 $88.46
Q9963 High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml <1% 14 $85.20
85049 <1% 51 $75.66
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) <1% 797 $75.24
J3480 Injection, potassium chloride, per 2 meq <1% 374 $74.15
29540 <1% 15 $74.10
95874 <1% 77 $72.81
J1040 Injection, methylprednisolone acetate, 80 mg <1% 14 $69.96
S0077 Injection, clindamycin phosphate, 300 mg <1% 57 $69.53
J3360 Injection, diazepam, up to 5 mg <1% 15 $59.08
J0360 Injection, hydralazine hcl, up to 20 mg <1% 36 $47.44
64643 <1% 18 $44.77
82270 <1% 16 $42.32
J0330 Injection, succinylcholine chloride, up to 20 mg <1% 247 $40.44
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 2,048 $38.91
J8540 Dexamethasone, oral, 0.25 mg <1% 68 $28.89
J1940 Injection, furosemide, up to 20 mg <1% 57 $28.26
J0131 Injection, acetaminophen, not otherwise specified,10 mg <1% 2,783 $27.63
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 93 $26.28
99152 <1% 15 $26.14
J1580 Injection, garamycin, gentamicin, up to 80 mg <1% 20 $24.36
J3411 Injection, thiamine hcl, 100 mg <1% 20 $24.32
89051 <1% 17 $23.10
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 1,390 $20.51
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 1,050 $20.06
J7644 Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram <1% 547 $14.00
94760 <1% 116 $13.45
64644 <1% 13 $13.33
A4351 Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each <1% 25 $3.93
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) <1% 77 $1.18
Q0243 Injection, casirivimab and imdevimab, 2400 mg <1% 120 $0.69
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml <1% 127 $0.48
Q0245 Injection, bamlanivimab and etesevimab, 2100 mg <1% 35 $0.12
91300 <1% 12 $0.08
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 0% 591 $0.00
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 0% 70 $0.00
C1769 Guide wire 0% 56 $0.00
90677 0% 12 $0.00
Q0247 Injection, sotrovimab, 500 mg 0% 37 $0.00
90673 0% 27 $0.00
J0574 Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine 0% 37 $0.00
J1790 Injection, droperidol, up to 5 mg 0% 13 $0.00
J0692 Injection, cefepime hydrochloride, 500 mg 0% 15 $0.00
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 0% 385 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 0% 160 $0.00
J0585 Injection, onabotulinumtoxina, 1 unit 0% 266 $0.00
J1171 Injection, hydromorphone, 0.1 mg 0% 303 $0.00
90750 0% 12 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 0% 41 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 0% 26 $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 officialSIMMONS, EILEEN (CFO)
Same official

Other billing entities under SIMMONS, EILEEN

Full network →
ProviderLocationPaid
Upmc Magee-Womens HospitalPittsburgh, PA$43.08M
Upmc Magee-Womens HospitalPittsburgh, PA$68K
Sutherland Family Practice INC.Sutherland, VA$11K
Upmc MercyPittsburgh, PA$326.70

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.