St Elizabeth Medical Center, INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 83 procedure codes: 99283 at 5.3× median, 99284 at 4.8× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $227.18 per claim for 99283 (Emergency dept visit, moderate complexity) — 5.3× the national median of $42.48.
Bills $336.08 per claim for 99284 (Emergency dept visit, high complexity) — 4.8× the national median of $69.51.
Bills $377.16 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 4.4× the national median of $85.65.
Billing above the 90th percentile for 9 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$188.3M
$188,250,923
Total Claims
4.3M
Beneficiaries
3.3M
1.3 claims/patient
Avg Cost/Claim
$44
#496 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
St Elizabeth Medical Center, INC is a Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier provider based in Edgewood, KY. From the 2018–2024 period, this provider received $188.3M in Medicaid payments across 4.3M claims.
Why This Matters
This provider received $188.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 23,531 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 14% of total spending.
$26.3M
116K claims
$227.18
$42.48
Emergency dept visit, moderate complexity
$26.3M
116K claims · 14.0%
$17.9M
53K claims
$336.08
$69.51
Emergency dept visit, high complexity
$17.9M
53K claims · 9.5%
$9.5M
25K claims
$377.16
$85.65
Emergency dept visit, high/urgent complexity
$9.5M
25K claims · 5.1%
Emergency dept visit, low complexity
$5.7M
39K claims · 3.0%
$4.3M
47K claims
$92.79
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$4.3M
47K claims · 2.3%
$4.2M
20K claims
$208.57
$99.39
Hospital observation service, per hour
$4.2M
20K claims · 2.2%
$4.2M
70K claims
$59.08
$35.43
Drug test, presumptive, by chemistry analyzers
$4.2M
70K claims · 2.2%
$4.1M
574 claims
$7,120.29
$5,391.55
Injection, pembrolizumab, 1 mg
$4.1M
574 claims · 2.2%
$4.1M
49K claims
$82.56
$37.56
Drug test, definitive, 1-7 drug classes
$4.1M
49K claims · 2.2%
$3.3M
45K claims
$72.62
$63.08
Infectious disease detection (COVID-19)
$3.3M
45K claims · 1.7%
CT abdomen and pelvis with contrast
$3.1M
15K claims · 1.7%
$2.9M
12K claims
$245.51
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$2.9M
12K claims · 1.5%
$2.3M
23K claims
$99.97
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$2.3M
23K claims · 1.2%
$2.3M
2K claims
$1,413.93
$183.33
Left heart catheterization with imaging
$2.3M
2K claims · 1.2%
$2.2M
8K claims
$290.09
$54.68
Echocardiography, transthoracic, complete, with Doppler
$2.2M
8K claims · 1.2%
Fetal non-stress test
$2.1M
17K claims · 1.1%
Unclassified drugs
$2.0M
146K claims · 1.1%
$2.0M
429K claims
$4.68
$1.57
Collection of venous blood by venipuncture
$2.0M
429K claims · 1.1%
$1.7M
4K claims
$431.26
$106.14
Myocardial perfusion imaging, SPECT, multiple studies
$1.7M
4K claims · 0.9%
$1.7M
41K claims
$41.90
$38.92
IV infusion, hydration, each additional hour
$1.7M
41K claims · 0.9%
Hospital outpatient clinic visit
$1.7M
25K claims · 0.9%
Comprehensive metabolic panel
$1.7M
196K claims · 0.9%
$1.6M
3K claims
$551.73
$123.40
Anchor or screw for tissue to bone fixation
$1.6M
3K claims · 0.9%
$1.5M
46K claims
$33.76
$28.46
Streptococcus Group A detection, nucleic acid, amplified probe
$1.5M
46K claims · 0.8%
$1.5M
45K claims
$33.95
$24.95
Chlamydia detection, nucleic acid, amplified probe
$1.5M
45K claims · 0.8%
Chest X-ray, 2 views
$1.4M
30K claims · 0.7%
PET imaging for limited area
$1.4M
2K claims · 0.7%
Thyroid stimulating hormone (TSH)
$1.4M
89K claims · 0.7%
$1.4M
12K claims · 0.7%
$1.3M
44K claims
$30.67
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$1.3M
44K claims · 0.7%
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