Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › MO › Saint Louis › NPI 1962572396
Hospital

SSM Health Care ST. Louis

SSM Health Care ST. Louis was paid $50.07M by Medicaid between Jan 2018 and Dec 2024, across 159 billing codes. Its largest line is X4011, State-specific procedure code — 15% of everything it billed.

33Billing provider infoSSM HEALTH CARE ST. LOUIS
SAINT LOUIS, MO 63117
33aNPI1962572396assigned 11/09/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$50.07M
24GClaims528,641
24DCodes billed159
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other General Acute Care Hospital providers in Missouri

Rank by total paid#6 of 74
Median peer was paid$4.44M
This provider vs. median11×

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$1.0M$2.0M2018201920202021202220232024
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
201875,508$15.27M
201968,526$11.40M
202052,845$4.98M
202174,467$2.31M
202285,895$4.53M
202397,405$6.45M
2024incomplete73,995$5.12M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
X4011 State-specific procedure code 15% 29,477 27,588 $7.59M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 11% 66,199 60,808 $5.50M
X4003 7.1% 25,248 17,137 $3.54M
85025 Blood count; complete (CBC), automated, and automated differential WBC count 6.4% 70,365 60,451 $3.21M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 5.6% 15,686 14,567 $2.80M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 5.3% 19,713 18,646 $2.66M
80053 Comprehensive metabolic panel 4.3% 50,018 45,605 $2.14M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 3.3% 10,355 9,497 $1.63M
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 3.2% 8,679 5,099 $1.62M
59025 Fetal non-stress test 3.2% 4,384 3,747 $1.59M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 2.9% 5,282 4,815 $1.45M
87086 Culture, bacterial; quantitative colony count, urine 2.0% 4,837 4,504 $978K
147 more codes
99213 Doctor's office visit, returning patient (routine) 1.9% 8,796 $955K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 1.9% 4,371 $950K
81001 1.8% 10,134 $905K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 1.7% 8,249 $841K
X4006 1.6% 1,984 $822K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 1.4% 15,093 $705K
87808 1.3% 4,235 $671K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1.2% 3,750 $617K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 1.2% 4,168 $614K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1.2% 3,754 $611K
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 1.1% 1,314 $528K
G0378 Hospital observation service, per hour <1% 953 $412K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 3,721 $365K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 2,172 $348K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 836 $337K
71046 Radiologic examination, chest; 2 views <1% 5,261 $337K
99214 Doctor's office visit, returning patient (more involved) <1% 1,590 $320K
84702 <1% 7,349 $306K
76818 <1% 2,943 $299K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 3,454 $298K
84484 <1% 12,475 $274K
90853 Group psychotherapy (other than of a multiple-family group) <1% 18,035 $245K
36415 Collection of venous blood by venipuncture <1% 3,409 $241K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 3,114 $236K
86780 <1% 2,860 $205K
81025 <1% 3,199 $182K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 804 $152K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 2,814 $148K
86900 <1% 848 $137K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 438 $125K
86901 <1% 843 $118K
71045 Radiologic examination, chest; single view <1% 3,325 $117K
86850 <1% 853 $114K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 1,276 $107K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 619 $101K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 2,287 $101K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 3,316 $95K
96375 Therapeutic injection; each additional sequential IV push <1% 2,617 $87K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 404 $76K
J3490 Unclassified drugs <1% 6,508 $69K
86592 <1% 181 $69K
86803 <1% 453 $60K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 257 $58K
81003 <1% 12,147 $56K
Y7506 <1% 380 $52K
87340 <1% 672 $48K
99203 Doctor's office visit, new patient (routine) <1% 4,767 $47K
36902 <1% 81 $45K
70450 Computed tomography, head or brain; without contrast material <1% 815 $45K
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% 3,107 $41K
86762 <1% 317 $36K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 301 $35K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 990 $35K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 78 $34K
82962 <1% 2,778 $33K
88142 <1% 167 $32K
82947 <1% 95 $26K
73630 <1% 118 $26K
76820 <1% 258 $26K
87428 <1% 985 $26K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 1,490 $26K
96361 Intravenous infusion, hydration; each additional hour <1% 526 $25K
87081 <1% 480 $25K
80055 <1% 63 $24K
80048 Basic metabolic panel (calcium, ionized) <1% 644 $22K
83690 <1% 3,516 $20K
90832 Psychotherapy session, about 30 minutes <1% 711 $19K
76801 <1% 133 $18K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 39 $17K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 1,630 $15K
83735 <1% 1,834 $14K
83020 <1% 60 $10K
73564 <1% 254 $10K
75710 <1% 64 $8K
87400 <1% 174 $8K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 343 $7K
95911 <1% 24 $7K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 16 $7K
62323 <1% 16 $6K
87536 <1% 145 $6K
83036 Hemoglobin; glycosylated (A1C) <1% 1,121 $6K
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% 253 $6K
76819 Fetal biophysical profile; without non-stress testing <1% 82 $6K
0240U <1% 45 $5K
76821 <1% 79 $5K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer <1% 272 $4K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 69 $3K
94726 <1% 12 $2K
95886 <1% 42 $2K
94060 <1% 13 $2K
Y7507 <1% 20 $2K
99204 Doctor's office visit, new patient (more involved) <1% 109 $2K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis <1% 14 $1K
83880 <1% 75 $1K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV <1% 29 $1K
93976 <1% 27 $1K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 15 $1K
77336 <1% 31 $1K
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% 223 $1K
88307 <1% 14 $991.90
83605 <1% 55 $869.97
80061 Lipid panel <1% 160 $859.12
99238 Hospital discharge day management, 30 minutes or less <1% 12 $741.96
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 15 $692.76
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 29 $623.12
73502 <1% 12 $585.71
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser <1% 894 $577.50
86361 <1% 38 $470.42
87430 <1% 26 $402.86
81002 <1% 155 $370.55
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 26 $342.68
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) <1% 630 $341.25
64483 <1% 16 $325.71
90480 <1% 34 $285.40
82657 <1% 14 $264.52
0124A <1% 13 $243.37
87899 <1% 14 $191.73
51798 <1% 13 $144.00
G0008 Administration of influenza virus vaccine <1% 47 $143.57
C1887 Catheter, guiding (may include infusion/perfusion capability) <1% 235 $139.50
85379 <1% 28 $131.07
C1769 Guide wire <1% 1,323 $122.25
J7050 Infusion, normal saline solution, 250 cc <1% 932 $114.22
85027 <1% 25 $84.04
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 820 $66.97
J1644 Injection, heparin sodium, per 1000 units <1% 1,553 $62.89
J2704 Injection, propofol, 10 mg <1% 344 $62.12
87205 <1% 13 $59.83
76937 <1% 40 $49.13
J7030 Infusion, normal saline solution , 1000 cc <1% 342 $48.73
80069 <1% 15 $41.25
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 359 $7.39
J3010 Injection, fentanyl citrate, 0.1 mg <1% 756 $2.52
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 332 $2.51
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program <1% 186 $0.16
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 0% 71 $0.00
36215 0% 40 $0.00
C1757 Catheter, thrombectomy/embolectomy 0% 12 $0.00
36416 0% 80 $0.00
87807 0% 57 $0.00
36591 0% 255 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 0% 335 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 0% 12 $0.00
99070 0% 134 $0.00
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 0% 42 $0.00
A9270 Non-covered item or service 0% 16 $0.00
C2623 Catheter, transluminal angioplasty, drug-coated, non-laser 0% 13 $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 officialCAPERS, TRAVIS (PRESIDENT)
Parent organizationSSM HEALTH CARE CORPORATION