Upper Cumberland Medical Clinic, INC.

Upper Cumberland Medical Clinic, INC. was paid $133K by Medicaid between Jul 2019 and Feb 2023, across 13 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 58% of everything it billed.

33Billing provider infoUPPER CUMBERLAND MEDICAL CLINIC, INC.
BAXTER, TN 38544

33aNPI1003302423assigned 07/09/2018

33bProvider typeClinic/Center

28Total paid$133K

24GClaims4,582

24DCodes billed13

24AFirst – last monthJul 2019 – Feb 2023

Compared with peers

Next to other Clinic/Center providers in Tennessee

Rank by total paid#29 of 70

Median peer was paid$72K

This provider vs. median1.9×

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
2019	378	$9K
2020	768	$23K
2021	2,110	$59K
2022	1,114	$36K
2023	212	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	58%	2,180	1,690	$78K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	37%	1,797	1,496	$49K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	3.2%	354	237	$4K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	17	13	$552.66
90756		<1%	47	39	$531.97
99443		<1%	16	15	$173.04
J1030	Injection, methylprednisolone acetate, 40 mg	<1%	35	28	$136.00
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	16	13	$123.87
G0008	Administration of influenza virus vaccine	<1%	29	26	$75.57
3079F		<1%	18	12	$60.00
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	36	26	$46.38
3074F		<1%	16	12	$10.00

1 more codes

J1100

Injection, dexamethasone sodium phosphate, 1 mg

<1%

$6.06

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 officialSWALLOWS, JACQUELINE (NURSE PRACTITIONER)