Physician
Monroe Medical Foundation, INC.
Monroe Medical Foundation, INC. was paid $632K by Medicaid between Jan 2018 and Oct 2024, across 19 billing codes. Its largest line is 99283, emergency room visit (moderate) — 36% of everything it billed.
33Billing provider infoMONROE MEDICAL FOUNDATION, INC.
TOMPKINSVILLE, KY 42167
TOMPKINSVILLE, KY 42167
33aNPI1114110202assigned 08/22/2007
33bProvider typeEmergency Medicine Physician
28Total paid$632K
24GClaims22,060
24DCodes billed19
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Emergency Medicine Physician providers in Kentucky
Rank by total paid#20 of 91
Median peer was paid$34K
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 | |
|---|---|---|---|
| 2018 | 4,175 | $126K | |
| 2019 | 4,159 | $129K | |
| 2020 | 2,482 | $77K | |
| 2021 | 3,403 | $80K | |
| 2022 | 2,890 | $67K | |
| 2023 | 3,033 | $100K | |
| 2024incomplete | 1,918 | $53K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 36% | 5,883 | 5,434 | $228K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 29% | 3,344 | 3,055 | $182K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 11% | 3,332 | 3,133 | $71K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.4% | 1,582 | 1,447 | $53K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 5.8% | 6,105 | 4,061 | $37K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 5.5% | 537 | 489 | $35K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.6% | 144 | 129 | $10K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 1.2% | 542 | 511 | $7K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 238 | 129 | $3K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 63 | 48 | $2K |
| 90686 | <1% | 79 | 73 | $1K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 32 | 29 | $747.11 |
7 more codes
| 93016 | <1% | 27 | $430.72 | |
| G0008 | Administration of influenza virus vaccine | <1% | 36 | $419.29 |
| 93018 | <1% | 27 | $351.36 | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 29 | $348.44 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 23 | $336.57 |
| 99217 | <1% | 16 | $213.76 | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 21 | $61.56 |
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 (CEO)
| Provider | Location | Paid |
|---|---|---|
| Monroe Medical Foundation, INC. | Tompkinsville, KY | $7.31M |
| Monroe Medical Foundation, INC. | Tompkinsville, KY | $1.30M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.