Physician
Clark Regional Physician Practices, LLC
Clark Regional Physician Practices, LLC was paid $9.45M by Medicaid between Jan 2018 and Dec 2024, across 173 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 29% of everything it billed.
33Billing provider infoCLARK REGIONAL PHYSICIAN PRACTICES, LLC
WINCHESTER, KY 40391
WINCHESTER, KY 40391
33aNPI1114282605assigned 07/10/2012
33bProvider typeInternal Medicine Physician
28Total paid$9.45M
24GClaims479,814
24DCodes billed173
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Kentucky
Rank by total paid#3 of 231
Median peer was paid$77K
This provider vs. median123×
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 BOWMAN, MONICA controls 20+ 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 | 86,194 | $1.95M | |
| 2019 | 76,877 | $1.78M | |
| 2020 | 62,924 | $1.42M | |
| 2021 | 74,936 | $1.83M | |
| 2022 | 43,694 | $841K | |
| 2023 | 83,688 | $879K | |
| 2024incomplete | 51,501 | $748K |
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 | 29% | 93,761 | 77,297 | $2.73M |
| 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 | 24% | 61,997 | 50,117 | $2.26M |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 6.3% | 9,258 | 7,619 | $598K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.6% | 4,614 | 4,400 | $340K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.5% | 5,160 | 4,747 | $333K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 3.3% | 4,081 | 3,096 | $311K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.7% | 5,174 | 4,371 | $258K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.4% | 19,117 | 16,482 | $227K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.3% | 16,441 | 7,993 | $220K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.9% | 13,296 | 12,486 | $179K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 1.9% | 1,526 | 1,165 | $176K |
| 95886 | 1.5% | 2,164 | 1,388 | $144K |
161 more codes
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.5% | 1,908 | $141K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 1.5% | 333 | $140K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.2% | 7,767 | $118K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 1.1% | 574 | $102K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 779 | $90K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 1,985 | $69K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 2,812 | $61K |
| 80305 | <1% | 11,366 | $61K | |
| 95911 | <1% | 488 | $59K | |
| 95912 | <1% | 335 | $49K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 2,170 | $44K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 2,392 | $42K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 438 | $37K |
| 87428 | <1% | 507 | $36K | |
| 11721 | <1% | 4,273 | $34K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 1,387 | $33K |
| 94060 | <1% | 2,696 | $32K | |
| 99441 | <1% | 1,486 | $32K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 409 | $28K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 856 | $26K |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | <1% | 122 | $23K |
| 43249 | <1% | 227 | $21K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 150 | $20K |
| 99223 | Prolong inpt eval add15 m | <1% | 470 | $20K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 1,323 | $19K |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,477 | $18K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 113 | $18K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 538 | $16K |
| 90474 | <1% | 1,716 | $15K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,394 | $15K |
| 64615 | <1% | 188 | $14K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 346 | $14K |
| 73630 | <1% | 998 | $13K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 618 | $13K |
| 99381 | <1% | 217 | $12K | |
| 94729 | <1% | 2,658 | $11K | |
| 99220 | <1% | 182 | $9K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 179 | $9K |
| 99217 | <1% | 484 | $9K | |
| 99460 | <1% | 227 | $9K | |
| 11043 | <1% | 135 | $8K | |
| 90670 | <1% | 4,047 | $7K | |
| 94726 | <1% | 1,170 | $7K | |
| 62323 | <1% | 84 | $7K | |
| 93000 | <1% | 586 | $7K | |
| 92557 | <1% | 231 | $6K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 87 | $6K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 124 | $5K |
| 51798 | <1% | 793 | $5K | |
| 92567 | <1% | 400 | $5K | |
| 51741 | <1% | 298 | $4K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 1,013 | $4K |
| 87807 | <1% | 319 | $4K | |
| 52000 | <1% | 162 | $4K | |
| 90682 | <1% | 119 | $4K | |
| 90686 | <1% | 1,590 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 58 | $4K |
| 94375 | <1% | 296 | $4K | |
| A5500 | For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe | <1% | 140 | $2K |
| 94618 | <1% | 203 | $2K | |
| 92588 | <1% | 54 | $2K | |
| 95909 | <1% | 34 | $2K | |
| 87430 | <1% | 132 | $2K | |
| 11056 | <1% | 403 | $2K | |
| 81002 | <1% | 4,235 | $2K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 304 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 121 | $2K |
| 94750 | <1% | 228 | $2K | |
| 95816 | <1% | 72 | $2K | |
| 99462 | <1% | 51 | $1K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 171 | $1K |
| 99152 | <1% | 235 | $1K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 78 | $1K |
| 94010 | <1% | 121 | $1K | |
| 99442 | <1% | 57 | $1K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 70 | $1K |
| 11045 | <1% | 49 | $1K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 27 | $1K |
| 94760 | <1% | 665 | $934.24 | |
| 93018 | <1% | 76 | $896.14 | |
| 99443 | <1% | 24 | $788.01 | |
| 99406 | <1% | 187 | $753.84 | |
| 90680 | <1% | 2,448 | $722.73 | |
| 90633 | <1% | 2,783 | $657.22 | |
| 31575 | <1% | 12 | $644.82 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 1,041 | $575.47 |
| 85018 | <1% | 150 | $381.06 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 26 | $326.91 |
| 81001 | <1% | 301 | $314.45 | |
| 56820 | <1% | 23 | $300.68 | |
| 90688 | <1% | 70 | $296.01 | |
| 90723 | <1% | 1,504 | $289.98 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 59 | $288.85 |
| 90473 | <1% | 508 | $263.66 | |
| 90651 | <1% | 90 | $239.29 | |
| 90461 | <1% | 14 | $220.00 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 35 | $210.68 |
| 51725 | <1% | 27 | $188.80 | |
| 90648 | <1% | 1,796 | $164.39 | |
| 87210 | <1% | 78 | $157.55 | |
| 92558 | <1% | 13 | $121.95 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 20 | $118.29 |
| 3078F | <1% | 9,528 | $116.73 | |
| 36416 | <1% | 114 | $115.48 | |
| 81003 | <1% | 262 | $113.50 | |
| 90685 | <1% | 360 | $98.72 | |
| 83655 | <1% | 15 | $98.51 | |
| 76000 | <1% | 52 | $82.04 | |
| 1036F | <1% | 16,989 | $78.80 | |
| 82043 | <1% | 21 | $70.40 | |
| 11055 | <1% | 25 | $68.33 | |
| 82570 | <1% | 21 | $63.07 | |
| 90707 | <1% | 257 | $57.82 | |
| 1034F | <1% | 8,665 | $40.00 | |
| 90885 | <1% | 53 | $33.75 | |
| 90700 | <1% | 287 | $24.18 | |
| 1159F | <1% | 21,125 | $21.79 | |
| 85014 | <1% | 15 | $18.03 | |
| 90634 | <1% | 58 | $13.20 | |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | <1% | 4,912 | $8.45 |
| 90698 | <1% | 341 | $5.31 | |
| S0020 | Injection, bupivicaine hydrochloride, 30 ml | <1% | 14 | $2.00 |
| 4013F | <1% | 100 | $1.74 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 27 | $0.48 |
| 3074F | <1% | 11,319 | $0.04 | |
| 1125F | <1% | 6,371 | $0.03 | |
| 90654 | <1% | 15 | $0.02 | |
| 90697 | <1% | 190 | $0.02 | |
| 3008F | <1% | 22,872 | $0.01 | |
| 3079F | <1% | 6,637 | $0.01 | |
| 90696 | <1% | 140 | $0.01 | |
| 90710 | <1% | 171 | $0.01 | |
| G9742 | Psychiatric symptoms assessed | 0% | 203 | $0.00 |
| 90716 | 0% | 306 | $0.00 | |
| 3080F | 0% | 2,219 | $0.00 | |
| 3075F | 0% | 2,132 | $0.00 | |
| 1220F | 0% | 3,949 | $0.00 | |
| G9226 | Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) | 0% | 1,338 | $0.00 |
| 4010F | 0% | 228 | $0.00 | |
| 1035F | 0% | 256 | $0.00 | |
| 1126F | 0% | 345 | $0.00 | |
| 90647 | 0% | 428 | $0.00 | |
| 4060F | 0% | 294 | $0.00 | |
| 99024 | 0% | 91 | $0.00 | |
| 3700F | 0% | 102 | $0.00 | |
| 90899 | 0% | 54 | $0.00 | |
| 90620 | 0% | 14 | $0.00 | |
| 1170F | 0% | 15 | $0.00 | |
| 90632 | 0% | 54 | $0.00 | |
| 3077F | 0% | 3,771 | $0.00 | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 0% | 879 | $0.00 |
| 1160F | 0% | 15,565 | $0.00 | |
| 4004F | 0% | 1,624 | $0.00 | |
| 3725F | 0% | 4,849 | $0.00 | |
| 90715 | 0% | 25 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 280 | $0.00 |
| G9621 | Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling | 0% | 22 | $0.00 |
| 90734 | 0% | 68 | $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% | 165 | $0.00 |
| H2027 | Psychoeducational service, per 15 minutes | 0% | 144 | $0.00 |
| 90671 | 0% | 14 | $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 officialBOWMAN, MONICA (VICE PRESIDENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.