NP / PA
Monroe Medical Foundation, INC.
Monroe Medical Foundation, INC. was paid $1.30M by Medicaid between Jan 2018 and Sep 2024, across 51 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 61% of everything it billed.
33Billing provider infoMONROE MEDICAL FOUNDATION, INC.
TOMPKINSVILLE, KY 42167
TOMPKINSVILLE, KY 42167
33aNPI1083854434assigned 02/25/2009
33bProvider typeNurse Practitioner
28Total paid$1.30M
24GClaims83,801
24DCodes billed51
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Nurse Practitioner providers in Kentucky
Rank by total paid#37 of 260
Median peer was paid$89K
This provider vs. median15×
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 | 9,923 | $235K | |
| 2019 | 21,584 | $320K | |
| 2020 | 16,994 | $244K | |
| 2021 | 15,200 | $204K | |
| 2022 | 14,000 | $201K | |
| 2023 | 5,621 | $89K | |
| 2024incomplete | 479 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 61% | 28,133 | 20,129 | $797K |
| 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 | 7.1% | 2,853 | 2,274 | $93K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 5.9% | 7,679 | 5,333 | $77K |
| 99219 | 4.2% | 980 | 840 | $55K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 3.3% | 2,553 | 2,016 | $43K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 3.0% | 515 | 454 | $40K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.4% | 2,267 | 1,674 | $31K |
| 99217 | 2.2% | 914 | 793 | $29K | |
| 99222 | Initial hospital care, per day, moderate complexity | 1.4% | 463 | 400 | $18K |
| 99225 | 1.4% | 610 | 524 | $18K | |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.3% | 605 | 515 | $16K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.2% | 697 | 299 | $15K |
39 more codes
| 20552 | <1% | 740 | $11K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 3,042 | $9K |
| 71045 | Radiologic examination, chest; single view | <1% | 814 | $8K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 182 | $7K |
| 99218 | <1% | 336 | $6K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 264 | $5K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 38 | $3K |
| 93000 | <1% | 249 | $3K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 72 | $3K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 33 | $2K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 4,661 | $2K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 33 | $1K |
| 90686 | <1% | 102 | $1K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 12 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 107 | $1K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 183 | $1K |
| 20550 | <1% | 78 | $987.63 | |
| 90674 | <1% | 74 | $911.47 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 798 | $855.91 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 12 | $785.80 |
| J0290 | Injection, ampicillin sodium, 500 mg | <1% | 760 | $610.57 |
| G0008 | Administration of influenza virus vaccine | <1% | 120 | $287.39 |
| 99422 | <1% | 21 | $286.44 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 12 | $195.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 265 | $133.83 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 18 | $113.84 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 13,201 | $61.86 |
| 81003 | <1% | 153 | $57.91 | |
| 3079F | <1% | 36 | $0.25 | |
| 3078F | <1% | 48 | $0.25 | |
| 3074F | <1% | 45 | $0.24 | |
| 1111F | <1% | 110 | $0.13 | |
| 3075F | <1% | 20 | $0.13 | |
| 3077F | <1% | 13 | $0.12 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 1,913 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 140 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 6,738 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 64 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 25 | $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 officialRICH-MCLERRAN, ANDREA (C.E.O.)
| Provider | Location | Paid |
|---|---|---|
| Monroe Medical Foundation, INC. | Tompkinsville, KY | $7.31M |
| Monroe Medical Foundation, INC. | Tompkinsville, KY | $632K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.