Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

CLARK REGIONAL PHYSICIAN PRACTICES, LLC

NPI: 1114282605 · WINCHESTER, KY 40391 · Internal Medicine Physician · NPI assigned 07/10/2012

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official BOWMAN, MONICA controls 20+ related entities in our dataset. Read more

$9.45M
Total Medicaid Paid
479,814
Total Claims
394,026
Beneficiaries
173
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOWMAN, MONICA (VICE PRESIDENT)
NPI Enumeration Date07/10/2012

Related Entities

Other providers sharing the same authorized official: BOWMAN, MONICA

ProviderCityStateTotal Paid
DLP MARQUETTE PHYSICIAN PRACTICES INC MARQUETTE MI $17.80M
KENTUCKY MSO, LLC GEORGETOWN KY $6.59M
CLARK REGIONAL PHYSICIAN PRACTICES LLC WINCHESTER KY $2.97M
PINELAKE PHYSICIAN PRACTICE, LLC MAYFIELD KY $2.26M
PORTAGE PHYSICIAN PRACTICES INC HANCOCK MI $1.63M
SPRING VIEW PHYSICIAN PRACTICES, LLC LEBANON KY $1.39M
COLORADO PLAINS PHYSICIAN PRACTICES LLC FORT MORGAN CO $1.28M
SPRING VIEW PHYSICIAN PRACTICES, LLC LEBANON KY $1.27M
NORTHWEST ALABAMA EMERGENCY MEDICINE LLC FLORENCE AL $1.24M
DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC HENDERSON NC $897K
BOURBON PHYSICIAN PRACTICE LLC PARIS KY $847K
PORTAGE PHYSICIAN PRACTICES INC. HOUGHTON MI $763K
DLP CONEMAUGH PHYSICIAN PRACTICES LLC ROARING SPRING PA $761K
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC SOMERSET KY $529K
KENTUCKY MSO LLC GEORGETOWN KY $406K
RCCH TRIOS PHYSICIANS LLC KENNEWICK WA $401K
NATIONAL PARK CARDIOLOGY SERVICES, LLC HOT SPRINGS AR $341K
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC SOMERSET KY $331K
KENTUCKY MSO LLC GEORGETOWN KY $282K
BOURBON PHYSICIAN PRACTICE LLC PARIS KY $266K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 51,501 $748K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 93,761 77,297 $2.73M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 61,997 50,117 $2.26M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 9,258 7,619 $598K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 4,614 4,400 $340K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 5,160 4,747 $333K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 4,081 3,096 $311K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 5,174 4,371 $258K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 19,117 16,482 $227K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 16,441 7,993 $220K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 13,296 12,486 $179K
45380 Colonoscopy, flexible; with biopsy, single or multiple 1,526 1,165 $176K
95886 2,164 1,388 $144K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,908 1,817 $141K
J0585 Injection, onabotulinumtoxina, 1 unit 333 153 $140K
90472 Immunization administration, each additional vaccine (list separately) 7,767 7,255 $118K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 574 417 $102K
99244 Office or other outpatient consultation, moderate to high complexity 779 729 $90K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,985 1,730 $69K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2,812 1,005 $61K
80305 11,366 8,004 $61K
95911 488 406 $59K
95912 335 290 $49K
99233 Prolong inpt eval add15 m 2,170 933 $44K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,392 1,913 $42K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 438 415 $37K
87428 507 408 $36K
11721 4,273 2,940 $34K
99239 Hospital discharge day management, more than 30 minutes 1,387 948 $33K
94060 2,696 2,237 $32K
99441 1,486 1,309 $32K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 409 147 $28K
99238 Hospital discharge day management, 30 minutes or less 856 652 $26K
42820 Tonsillectomy and adenoidectomy; younger than age 12 122 113 $23K
43249 227 180 $21K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 150 132 $20K
99223 Prolong inpt eval add15 m 470 316 $20K
99232 Subsequent hospital care, per day, moderate complexity 1,323 626 $19K
36415 Collection of venous blood by venipuncture 5,477 4,420 $18K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 113 94 $18K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 538 415 $16K
90474 1,716 1,649 $15K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,394 1,002 $15K
64615 188 170 $14K
99222 Initial hospital care, per day, moderate complexity 346 279 $14K
73630 998 687 $13K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 618 538 $13K
99381 217 178 $12K
94729 2,658 2,203 $11K
99220 182 123 $9K
90792 Psychiatric diagnostic evaluation with medical services 179 106 $9K
99217 484 341 $9K
99460 227 196 $9K
11043 135 53 $8K
90670 4,047 3,877 $7K
94726 1,170 911 $7K
62323 84 76 $7K
93000 586 517 $7K
92557 231 203 $6K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 87 75 $6K
99215 Prolong outpt/office vis 124 116 $5K
51798 793 567 $5K
92567 400 362 $5K
51741 298 196 $4K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1,013 633 $4K
87807 319 286 $4K
52000 162 115 $4K
90682 119 110 $4K
90686 1,590 1,508 $4K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 58 53 $4K
94375 296 225 $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 140 46 $2K
94618 203 165 $2K
92588 54 46 $2K
95909 34 26 $2K
87430 132 124 $2K
11056 403 241 $2K
81002 4,235 3,402 $2K
83036 Hemoglobin; glycosylated (A1C) 304 249 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 121 104 $2K
94750 228 182 $2K
95816 72 60 $2K
99462 51 41 $1K
99231 Subsequent hospital care, per day, straightforward or low complexity 171 57 $1K
99152 235 177 $1K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 78 49 $1K
94010 121 82 $1K
99442 57 51 $1K
90460 Immunization administration through 18 years of age via any route, first or only component 70 67 $1K
11045 49 14 $1K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 27 24 $1K
94760 665 543 $934.24
93018 76 67 $896.14
99443 24 20 $788.01
99406 187 127 $753.84
90680 2,448 2,346 $722.73
90633 2,783 2,663 $657.22
31575 12 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) 1,041 916 $575.47
85018 150 145 $381.06
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 26 26 $326.91
81001 301 247 $314.45
56820 23 12 $300.68
90688 70 68 $296.01
90723 1,504 1,447 $289.98
J1030 Injection, methylprednisolone acetate, 40 mg 59 39 $288.85
90473 508 485 $263.66
90651 90 89 $239.29
90461 14 14 $220.00
J1040 Injection, methylprednisolone acetate, 80 mg 35 24 $210.68
51725 27 14 $188.80
90648 1,796 1,726 $164.39
87210 78 51 $157.55
92558 13 13 $121.95
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 20 16 $118.29
3078F 9,528 8,341 $116.73
36416 114 110 $115.48
81003 262 230 $113.50
90685 360 357 $98.72
83655 15 12 $98.51
76000 52 38 $82.04
1036F 16,989 14,094 $78.80
82043 21 18 $70.40
11055 25 13 $68.33
82570 21 18 $63.07
90707 257 247 $57.82
1034F 8,665 7,638 $40.00
90885 53 31 $33.75
90700 287 273 $24.18
1159F 21,125 17,978 $21.79
85014 15 12 $18.03
90634 58 54 $13.20
G9622 Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method 4,912 3,545 $8.45
90698 341 328 $5.31
S0020 Injection, bupivicaine hydrochloride, 30 ml 14 12 $2.00
4013F 100 84 $1.74
J1100 Injection, dexamethasone sodium phosphate, 1 mg 27 12 $0.48
3074F 11,319 9,815 $0.04
1125F 6,371 5,578 $0.03
90654 15 14 $0.02
90697 190 184 $0.02
3008F 22,872 20,587 $0.01
3079F 6,637 5,739 $0.01
90696 140 136 $0.01
90710 171 165 $0.01
G9742 Psychiatric symptoms assessed 203 120 $0.00
90716 306 297 $0.00
3080F 2,219 1,971 $0.00
3075F 2,132 1,903 $0.00
1220F 3,949 2,741 $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) 1,338 931 $0.00
4010F 228 182 $0.00
1035F 256 230 $0.00
1126F 345 313 $0.00
90647 428 413 $0.00
4060F 294 171 $0.00
99024 91 86 $0.00
3700F 102 66 $0.00
90899 54 35 $0.00
90620 14 12 $0.00
1170F 15 12 $0.00
90632 54 51 $0.00
3077F 3,771 3,378 $0.00
T1015 Clinic visit/encounter, all-inclusive 879 673 $0.00
1160F 15,565 13,891 $0.00
4004F 1,624 1,167 $0.00
3725F 4,849 4,284 $0.00
90715 25 24 $0.00
G8482 Influenza immunization administered or previously received 280 258 $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 22 15 $0.00
90734 68 63 $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) 165 140 $0.00
H2027 Psychoeducational service, per 15 minutes 144 86 $0.00
90671 14 13 $0.00