Clinic
Big Sandy Health Care, INC
Big Sandy Health Care, INC was paid $2.30M by Medicaid between Jan 2018 and Dec 2024, across 78 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 32% of everything it billed.
33Billing provider infoBIG SANDY HEALTH CARE, INC
INEZ, KY 41224
INEZ, KY 41224
33aNPI1104055805assigned 07/02/2009
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$2.30M
24GClaims114,726
24DCodes billed78
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Kentucky
Rank by total paid#15 of 37
Median peer was paid$1.29M
This provider vs. median1.8×
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 | 14,378 | $266K | |
| 2019 | 20,509 | $394K | |
| 2020 | 13,517 | $316K | |
| 2021 | 15,978 | $288K | |
| 2022 | 15,906 | $326K | |
| 2023 | 19,388 | $394K | |
| 2024incomplete | 15,050 | $320K |
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 | 32% | 22,994 | 19,498 | $744K |
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 9,414 | 9,202 | $248K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.9% | 6,146 | 5,993 | $227K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 5.1% | 1,726 | 1,687 | $118K |
| D1206 | Topical application of fluoride varnish | 3.5% | 5,830 | 5,702 | $80K |
| D0274 | Bitewings - four radiographic images | 3.3% | 2,567 | 2,498 | $77K |
| D1351 | Sealant - per tooth | 2.8% | 3,710 | 1,453 | $65K |
| D0272 | Bitewings - two radiographic images | 2.8% | 3,592 | 3,525 | $65K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 2.5% | 1,619 | 832 | $59K |
| D1110 | Prophylaxis - adult | 2.4% | 1,302 | 1,269 | $56K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 2.1% | 1,521 | 1,395 | $48K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.0% | 3,784 | 1,830 | $47K |
66 more codes
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 1.9% | 461 | $44K |
| 90837 | Psychotherapy session, about an hour | 1.9% | 586 | $44K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.9% | 3,251 | $43K |
| V2020 | Frames, purchases | 1.5% | 1,680 | $36K |
| 99214 | Doctor's office visit, returning patient (more involved) | 1.3% | 681 | $30K |
| G0467 | Community health center visit, returning patient | 1.2% | 4,386 | $29K |
| D1208 | Topical application of fluoride, excluding varnish | 1.1% | 2,135 | $26K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 2,190 | $25K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.1% | 4,240 | $25K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.1% | 677 | $24K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 735 | $17K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,047 | $16K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 784 | $13K |
| D0330 | Panoramic radiographic image | <1% | 261 | $12K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,534 | $11K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 345 | $10K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 195 | $9K |
| 92015 | Determination of refractive state | <1% | 2,634 | $8K |
| 99173 | <1% | 340 | $8K | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 1,796 | $6K |
| 90785 | <1% | 425 | $3K | |
| V2744 | Tint, photochromatic, per lens | <1% | 93 | $3K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 319 | $3K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 372 | $3K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 96 | $3K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 26 | $2K |
| 99382 | <1% | 34 | $2K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 33 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 65 | $2K |
| D1330 | <1% | 3,917 | $2K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 176 | $1K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 174 | $959.59 |
| 90756 | <1% | 46 | $689.10 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 105 | $643.68 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 15 | $589.40 |
| 80305 | <1% | 62 | $542.76 | |
| 90686 | <1% | 197 | $539.29 | |
| 90674 | <1% | 33 | $535.43 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 18 | $477.23 |
| 92341 | <1% | 14 | $462.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 197 | $390.07 |
| 90661 | <1% | 18 | $361.62 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 472 | $351.44 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 33 | $302.26 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 14 | $182.00 |
| 81003 | <1% | 225 | $167.37 | |
| 92551 | <1% | 13 | $119.34 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 19 | $118.58 |
| 36416 | <1% | 87 | $93.32 | |
| 81001 | <1% | 55 | $75.71 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 16 | $58.94 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 13 | $22.80 |
| 3044F | <1% | 475 | $2.03 | |
| 3078F | <1% | 99 | $0.34 | |
| 3074F | <1% | 58 | $0.30 | |
| 90633 | <1% | 36 | $0.07 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 2,105 | $0.01 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 1,475 | $0.00 |
| 4004F | 0% | 1,738 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 194 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 79 | $0.00 |
| A4617 | Mouth piece | 0% | 17 | $0.00 |
| D0999 | Unspecified diagnostic procedure, by report | 0% | 1,815 | $0.00 |
| G8433 | Screening for depression not completed, documented patient or medical reason | 0% | 16 | $0.00 |
| 1036F | 0% | 13 | $0.00 | |
| D9995 | 0% | 61 | $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 officialHERALD, JAMES (CEO)
| Provider | Location | Paid |
|---|---|---|
| Big Sandy Health Care INC | Auxier, KY | $4.57M |
| Big Sandy Health Care INC | Salyersville, KY | $1.99M |
| Big Sandy Health Care INC | Grethel, KY | $1.74M |
| Big Sandy Health Care INC | Pikeville, KY | $1.73M |
| Big Sandy Health Care INC | Salyersville, KY | $1.01M |
| Big Sandy Health Care INC | Pikeville, KY | $530K |
| Big Sandy Health Care INC | Harold, KY | $416K |
| The Pathology Group PC | Memphis, TN | $380K |
| Big Sandy Health Care INC | Freeburn, KY | $114K |
| Big Sandy Health Care INC | Paintsville, KY | $48K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.