Clinic
Pineville Community Health Center INC
Pineville Community Health Center INC was paid $7.49M by Medicaid between Sep 2020 and Dec 2024, across 7 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 62% of everything it billed.
33Billing provider infoPINEVILLE COMMUNITY HEALTH CENTER INC
PINEVILLE, KY 40977
PINEVILLE, KY 40977
33aNPI1073171849assigned 06/05/2019
33bProvider typeRural Health Clinic/Center
28Total paid$7.49M
24GClaims66,128
24DCodes billed7
24AFirst – last monthSep 2020 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Kentucky
Rank by total paid#6 of 265
Median peer was paid$400K
This provider vs. median19×
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 | |
|---|---|---|---|
| 2020 | 259 | $4K | |
| 2021 | 406 | $4K | |
| 2023 | 29,998 | $3.41M | |
| 2024incomplete | 35,465 | $4.07M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 62% | 34,985 | 14,559 | $4.61M |
| 99308 | Subsequent nursing facility care, per day, straightforward | 32% | 25,244 | 12,845 | $2.43M |
| 99310 | Prolong nursin fac eval 15m | 3.2% | 1,267 | 1,030 | $238K |
| 99307 | 2.7% | 3,810 | 2,620 | $201K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 565 | 340 | $7K |
| 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% | 187 | 133 | $3K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 70 | 40 | $2K |
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 officialRICHTER, SHERYL (PRESIDENT/CEO)
| Provider | Location | Paid |
|---|---|---|
| Pineville Community Health Center INC | Pineville, KY | $3.65M |
| Pineville Community Hospital Association, INC. | Pineville, KY | $59K |
| Pineville Community Health Center INC | Pineville, KY | $10K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.