Managed care
Fulcrum Health, INC.
Fulcrum Health, INC. was paid $10.06M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is 98941, Chiropractic manipulative treatment; spinal, 3-4 regions — 68% of everything it billed.
33Billing provider infoFULCRUM HEALTH, INC.
PLYMOUTH, MN 55447
PLYMOUTH, MN 55447
33aNPI1003000969assigned 09/04/2007
33bProvider typeExclusive Provider Organization
28Total paid$10.06M
24GClaims440,544
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Exclusive Provider Organization providers in Minnesota
Rank by total paid#2 of 12
Median peer was paid$3.02M
This provider vs. median3.3×
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
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 | 93,480 | $383K | |
| 2019 | 81,384 | $2.18M | |
| 2020 | 80,256 | $2.22M | |
| 2021 | 110,037 | $3.07M | |
| 2022 | 62,216 | $1.86M | |
| 2023 | 8,535 | $216K | |
| 2024incomplete | 4,636 | $136K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | 68% | 263,962 | 122,534 | $6.83M |
| 98940 | 15% | 76,251 | 37,830 | $1.54M | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.2% | 10,093 | 9,134 | $426K |
| 97810 | 3.6% | 18,976 | 8,229 | $366K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 3.1% | 9,861 | 8,835 | $310K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.5% | 4,767 | 4,332 | $154K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 6,646 | 5,988 | $131K |
| 72100 | <1% | 2,312 | 2,054 | $62K | |
| 97813 | <1% | 2,387 | 1,061 | $57K | |
| 72040 | <1% | 1,999 | 1,760 | $50K | |
| 97811 | <1% | 3,005 | 1,140 | $43K | |
| 98942 | <1% | 1,302 | 701 | $39K |
14 more codes
| 99201 | <1% | 1,685 | $28K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,296 | $14K |
| 72070 | <1% | 231 | $6K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 5,241 | $3K |
| 97014 | <1% | 10,492 | $2K | |
| 98943 | <1% | 5,657 | $2K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 5,212 | $1K |
| 97012 | <1% | 5,953 | $846.10 | |
| 97035 | <1% | 1,620 | $844.30 | |
| 97032 | <1% | 594 | $114.70 | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 133 | $58.14 |
| 97010 | 0% | 233 | $0.00 | |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 365 | $0.00 |
| S9999 | Sales tax | 0% | 271 | $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 officialDENNIS, PATRICIA (CEO)