Community Care of West Virginia, INC.
Community Care of West Virginia, INC. was paid $606K by Medicaid between Jan 2018 and Dec 2024, across 21 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 96% of everything it billed.
BUCKHANNON, WV 26201
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 469 | $38K | |
| 2019 | 419 | $34K | |
| 2020 | 586 | $37K | |
| 2021 | 316 | $17K | |
| 2022 | 1,006 | $78K | |
| 2023 | 2,513 | $191K | |
| 2024incomplete | 2,275 | $212K |
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 | 96% | 2,836 | 2,179 | $580K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.1% | 1,698 | 1,336 | $12K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 638 | 554 | $5K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 441 | 399 | $3K |
| 87428 | <1% | 201 | 177 | $3K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 25 | 25 | $1K |
| 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% | 21 | 19 | $832.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 577 | 475 | $680.19 |
| 90686 | <1% | 215 | 192 | $308.50 | |
| 90656 | <1% | 57 | 57 | $22.14 | |
| 90620 | <1% | 144 | 124 | $12.00 | |
| 1126F | 0% | 38 | 38 | $0.00 |
9 more codes
| 90619 | 0% | 14 | $0.00 | |
| 1036F | 0% | 101 | $0.00 | |
| 3074F | 0% | 110 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 29 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 97 | $0.00 |
| 1160F | 0% | 99 | $0.00 | |
| 1159F | 0% | 99 | $0.00 | |
| 3078F | 0% | 104 | $0.00 | |
| 99173 | 0% | 40 | $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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Community Care of West Virginia, INC. | Buckhannon, WV | $6.32M |
| Community Care of West Virginia, INC. | Sutton, WV | $324K |
| Community Care of West Virginia, INC. | Sutton, WV | $156K |
| Community Care of West Virginia, INC. | Buckhannon, WV | $129K |
| Community Care of West Virginia, INC. | Green Bank, WV | $126K |
| Community Care of West Virginia, INC. | Dunmore, WV | $95K |
| Community Care of West Virginia, INC. | Green Bank, WV | $16K |
| Community Care of West Virginia, INC. | French Creek, WV | $13K |
| Community Care of West Virginia, INC. | Lost Creek, WV | $6K |
| Community Care of West Virginia, INC. | Marlinton, WV | $1K |
| Wolfe-Simon Medical Associates PA | Cherry Hill, NJ | $599.76 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.