Clinic
Five Rivers Health Centers
Five Rivers Health Centers was paid $13.10M by Medicaid between Jan 2018 and Dec 2024, across 114 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 73% of everything it billed.
33Billing provider infoFIVE RIVERS HEALTH CENTERS
DAYTON, OH 45406
DAYTON, OH 45406
33aNPI1114280690assigned 06/20/2012
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$13.10M
24GClaims389,613
24DCodes billed114
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Ohio
Rank by total paid#14 of 348
Median peer was paid$1.33M
This provider vs. median9.9×
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 MCFARLANE-EL, GINA controls 14+ 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 | 81,454 | $1.72M | |
| 2019 | 64,439 | $1.87M | |
| 2020 | 56,807 | $1.98M | |
| 2021 | 68,042 | $2.50M | |
| 2022 | 43,642 | $1.98M | |
| 2023 | 46,878 | $1.97M | |
| 2024incomplete | 28,351 | $1.08M |
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 | 73% | 100,984 | 82,933 | $9.61M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 113,987 | 65,167 | $2.43M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.7% | 45,156 | 10,832 | $354K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.1% | 7,194 | 4,036 | $145K |
| 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% | 3,461 | 2,016 | $114K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 7,065 | 3,874 | $96K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 2,561 | 1,665 | $64K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 1,902 | 1,195 | $49K |
| 90686 | <1% | 6,819 | 3,852 | $36K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,336 | 1,985 | $29K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 2,019 | 1,001 | $26K |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | <1% | 1,760 | 1,206 | $25K |
102 more codes
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 649 | $15K |
| T2003 | Non-emergency transportation, per trip | <1% | 1,109 | $11K |
| 0051A | <1% | 298 | $10K | |
| 0064A | <1% | 253 | $8K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 645 | $8K |
| D1110 | Prophylaxis - adult | <1% | 235 | $7K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 92 | $5K |
| D1351 | Sealant - per tooth | <1% | 536 | $5K |
| 92551 | <1% | 1,655 | $5K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 204 | $5K |
| 99401 | <1% | 242 | $4K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,643 | $4K |
| 90656 | <1% | 351 | $4K | |
| 90746 | <1% | 83 | $3K | |
| D0330 | Panoramic radiographic image | <1% | 74 | $3K |
| D0120 | Dental checkup, returning patient | <1% | 181 | $3K |
| 0071A | <1% | 71 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 516 | $2K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 47 | $2K |
| D0274 | Bitewings - four radiographic images | <1% | 112 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 156 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 111 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 116 | $1K |
| D1120 | Dental cleaning, child | <1% | 86 | $1K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 37 | $1K |
| 99381 | <1% | 105 | $1K | |
| 99173 | <1% | 831 | $1K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 57 | $930.30 |
| 90677 | <1% | 334 | $894.12 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 129 | $714.09 |
| 0072A | <1% | 16 | $691.80 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 103 | $666.68 |
| 99442 | <1% | 53 | $548.07 | |
| 3077F | <1% | 241 | $450.00 | |
| 90474 | <1% | 91 | $412.24 | |
| 3046F | <1% | 605 | $340.04 | |
| 90715 | <1% | 21 | $312.63 | |
| 90633 | <1% | 273 | $307.83 | |
| 0011A | <1% | 20 | $304.64 | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 83 | $295.00 |
| 3079F | <1% | 183 | $260.00 | |
| 90670 | <1% | 1,351 | $250.14 | |
| 82044 | <1% | 271 | $240.41 | |
| D0272 | Bitewings - two radiographic images | <1% | 24 | $240.00 |
| 3074F | <1% | 174 | $240.00 | |
| 81003 | <1% | 251 | $202.15 | |
| 81025 | <1% | 179 | $195.46 | |
| 3080F | <1% | 84 | $145.00 | |
| 99383 | <1% | 40 | $135.74 | |
| 11721 | <1% | 19 | $115.90 | |
| 3044F | <1% | 107 | $100.00 | |
| 90674 | <1% | 53 | $64.56 | |
| 85018 | <1% | 55 | $51.42 | |
| 81002 | <1% | 280 | $45.98 | |
| 3008F | <1% | 133 | $30.00 | |
| 3078F | <1% | 20 | $25.00 | |
| 87220 | <1% | 61 | $8.80 | |
| 87210 | <1% | 70 | $8.80 | |
| 91305 | <1% | 343 | $3.04 | |
| 91306 | <1% | 254 | $1.91 | |
| 91307 | <1% | 145 | $1.34 | |
| 91301 | <1% | 31 | $0.25 | |
| 1036F | 0% | 25,210 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 10,115 | $0.00 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 4,461 | $0.00 |
| G8756 | No documentation of blood pressure measurement, reason not given | 0% | 858 | $0.00 |
| 3017F | 0% | 1,664 | $0.00 | |
| 90744 | 0% | 273 | $0.00 | |
| 90698 | 0% | 528 | $0.00 | |
| 1123F | 0% | 394 | $0.00 | |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 846 | $0.00 |
| 90651 | 0% | 21 | $0.00 | |
| 90697 | 0% | 144 | $0.00 | |
| 3014F | 0% | 379 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 731 | $0.00 |
| 93000 | 0% | 27 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 0% | 16 | $0.00 |
| 82962 | 0% | 15 | $0.00 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 0% | 55 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 18 | $0.00 |
| D1310 | 0% | 19 | $0.00 | |
| D1330 | 0% | 26 | $0.00 | |
| 3351F | 0% | 14 | $0.00 | |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 57 | $0.00 |
| 90716 | 0% | 17 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 8,224 | $0.00 |
| 4004F | 0% | 13,751 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 1,914 | $0.00 |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 622 | $0.00 |
| 3051F | 0% | 21 | $0.00 | |
| 90648 | 0% | 23 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 5,569 | $0.00 |
| 90707 | 0% | 17 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 114 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 12 | $0.00 |
| 90681 | 0% | 172 | $0.00 | |
| 1160F | 0% | 152 | $0.00 | |
| 1159F | 0% | 76 | $0.00 | |
| 3045F | 0% | 53 | $0.00 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 0% | 14 | $0.00 |
| 4040F | 0% | 16 | $0.00 | |
| G8598 | Aspirin or another antiplatelet therapy used | 0% | 139 | $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 officialMCFARLANE-EL, GINA (CEO)
| Provider | Location | Paid |
|---|---|---|
| Five Rivers Health Centers | Dayton, OH | $7.95M |
| Five Rivers Health Centers | Xenia, OH | $2.54M |
| Five Rivers Health Centers | Xenia, OH | $2.08M |
| Five Rivers Health Centers | Dayton, OH | $1.76M |
| Five Rivers Health Centers | Dayton, OH | $755K |
| Five Rivers Health Centers | Dayton, OH | $208K |
| Five Rivers Health Centers | Dayton, OH | $121K |
| Five Rivers Health Centers | Dayton, OH | $115K |
| Five Rivers Health Centers | Dayton, OH | $102K |
| Five Rivers Health Centers | Xenia, OH | $18K |
| Five Rivers Health Centers | Dayton, OH | $14K |
| Five Rivers Health Centers | Dayton, OH | $7K |
| Five Rivers Health Centers | Dayton, OH | $7K |
| Five Rivers Health Centers | Xenia, OH | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.