Appalachian Regional Healthcare, INC.
Appalachian Regional Healthcare, INC. was paid $451K by Medicaid between Jan 2018 and Nov 2024, across 30 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 30% of everything it billed.
MIDDLESBORO, KY 40965
Next to other Nurse Practitioner providers in Kentucky
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 | 2,723 | $41K | |
| 2019 | 5,309 | $97K | |
| 2020 | 2,724 | $59K | |
| 2021 | 3,249 | $81K | |
| 2022 | 2,512 | $52K | |
| 2023 | 3,049 | $72K | |
| 2024incomplete | 1,411 | $48K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 30% | 7,696 | 2,396 | $135K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 19% | 2,699 | 2,320 | $86K |
| 99239 | Hospital discharge day management, more than 30 minutes | 17% | 2,311 | 1,883 | $75K |
| 99222 | Initial hospital care, per day, moderate complexity | 8.3% | 956 | 785 | $38K |
| 99223 | Prolong inpt eval add15 m | 6.3% | 685 | 538 | $28K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 4.6% | 948 | 313 | $21K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.5% | 1,189 | 885 | $16K |
| 99220 | 2.6% | 221 | 170 | $12K | |
| 99217 | 1.8% | 341 | 282 | $8K | |
| 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 | 1.1% | 140 | 91 | $5K |
| 99219 | <1% | 64 | 52 | $3K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 317 | 115 | $3K |
18 more codes
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 107 | $3K |
| 20610 | <1% | 303 | $2K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 109 | $2K |
| 81025 | <1% | 161 | $2K | |
| 99225 | <1% | 120 | $2K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 39 | $2K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 109 | $2K |
| 71045 | Radiologic examination, chest; single view | <1% | 1,272 | $2K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 124 | $1K |
| 88304 | <1% | 150 | $916.52 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 41 | $767.28 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 628 | $548.08 |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 135 | $451.92 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 19 | $376.06 |
| 99224 | <1% | 24 | $316.78 | |
| 71250 | <1% | 41 | $182.00 | |
| 76770 | <1% | 13 | $32.32 | |
| 72100 | <1% | 15 | $27.16 |
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
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.