Clinic
Community Care of West Virginia, INC.
Community Care of West Virginia, INC. was paid $9.10M by Medicaid between Jan 2018 and Dec 2024, across 64 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 92% of everything it billed.
33Billing provider infoCOMMUNITY CARE OF WEST VIRGINIA, INC.
CLAY, WV 25043
CLAY, WV 25043
33aNPI1073562641assigned 05/09/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$9.10M
24GClaims132,934
24DCodes billed64
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
Rank by total paid#14 of 205
Median peer was paid$521K
This provider vs. median17×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official POTASNIK, DORA controls 20+ related entities in our dataset. Read more
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 | 13,849 | $877K | |
| 2019 | 6,569 | $398K | |
| 2020 | 14,981 | $810K | |
| 2021 | 16,361 | $968K | |
| 2022 | 26,281 | $1.99M | |
| 2023 | 29,021 | $2.31M | |
| 2024incomplete | 25,872 | $1.74M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 92% | 49,794 | 39,283 | $8.35M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.7% | 27,386 | 21,992 | $243K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.8% | 4,626 | 4,147 | $166K |
| 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 | 1.2% | 11,209 | 9,535 | $107K |
| 87428 | <1% | 2,435 | 2,178 | $54K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,628 | 2,286 | $35K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,161 | 1,889 | $20K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 1,037 | 965 | $20K |
| 81002 | <1% | 697 | 639 | $18K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 1,119 | 1,004 | $12K |
| 90686 | <1% | 821 | 720 | $9K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 378 | 361 | $8K |
52 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 560 | $7K |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 968 | $7K |
| 92551 | <1% | 787 | $6K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,053 | $6K |
| 81025 | <1% | 124 | $5K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 196 | $5K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 95 | $4K |
| 90715 | <1% | 90 | $3K | |
| 90707 | <1% | 77 | $3K | |
| 90674 | <1% | 72 | $3K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 43 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 224 | $2K |
| 90670 | <1% | 28 | $2K | |
| 90688 | <1% | 22 | $1K | |
| 90648 | <1% | 13 | $928.60 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 85 | $761.15 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 78 | $761.14 |
| 90633 | <1% | 14 | $729.69 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 13 | $616.53 |
| 90746 | <1% | 14 | $152.71 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 13 | $55.24 |
| 92250 | <1% | 12 | $51.40 | |
| 1036F | 0% | 1,904 | $0.00 | |
| 90656 | 0% | 27 | $0.00 | |
| 99000 | 0% | 1,384 | $0.00 | |
| 3074F | 0% | 3,405 | $0.00 | |
| 1125F | 0% | 1,755 | $0.00 | |
| 3075F | 0% | 708 | $0.00 | |
| 3079F | 0% | 576 | $0.00 | |
| 1034F | 0% | 1,375 | $0.00 | |
| 1035F | 0% | 188 | $0.00 | |
| 3044F | 0% | 86 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 136 | $0.00 |
| 1126F | 0% | 1,325 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 92 | $0.00 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 0% | 75 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 60 | $0.00 |
| 90632 | 0% | 13 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 27 | $0.00 |
| 1160F | 0% | 3,030 | $0.00 | |
| 1159F | 0% | 3,079 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 748 | $0.00 |
| 3077F | 0% | 16 | $0.00 | |
| 3078F | 0% | 3,784 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 12 | $0.00 |
| 99173 | 0% | 16 | $0.00 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 0% | 12 | $0.00 |
| 81003 | 0% | 135 | $0.00 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 0% | 14 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 55 | $0.00 |
| 91300 | 0% | 12 | $0.00 | |
| 90662 | 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 officialPOTASNIK, DORA (CREDENTIALING)
Parent organizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.