Physician
Knox Community Hospital
Knox Community Hospital was paid $5.70M by Medicaid between Jan 2018 and Dec 2024, across 122 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 48% of everything it billed.
33Billing provider infoKNOX COMMUNITY HOSPITAL
MOUNT VERNON, OH 43050
MOUNT VERNON, OH 43050
33aNPI1154483022assigned 12/15/2006
33bProvider typeFamily Medicine Physician
28Total paid$5.70M
24GClaims333,328
24DCodes billed122
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Ohio
Rank by total paid#20 of 739
Median peer was paid$30K
This provider vs. median192×
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 | 37,229 | $772K | |
| 2019 | 45,553 | $950K | |
| 2020 | 40,707 | $805K | |
| 2021 | 50,364 | $892K | |
| 2022 | 65,649 | $962K | |
| 2023 | 55,643 | $711K | |
| 2024incomplete | 38,183 | $607K |
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 | 48% | 112,465 | 97,231 | $2.76M |
| 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 | 32% | 62,099 | 54,304 | $1.80M |
| 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 | 2.8% | 3,833 | 3,571 | $158K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.5% | 15,830 | 5,705 | $141K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.1% | 4,078 | 3,847 | $118K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.9% | 3,421 | 3,026 | $106K |
| 31231 | 1.8% | 4,433 | 3,767 | $105K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.7% | 2,736 | 2,580 | $99K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.6% | 7,115 | 6,657 | $92K |
| 20610 | <1% | 2,801 | 2,365 | $51K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 749 | 658 | $27K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 2,678 | 1,246 | $22K |
110 more codes
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 482 | $17K |
| 31237 | <1% | 130 | $15K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 169 | $15K |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 558 | $15K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 277 | $12K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 495 | $11K |
| 31575 | <1% | 277 | $10K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 103 | $8K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 511 | $8K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 190 | $7K |
| 96127 | <1% | 2,579 | $6K | |
| 99406 | <1% | 1,334 | $6K | |
| 93298 | <1% | 286 | $5K | |
| 92557 | <1% | 220 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 99 | $4K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 839 | $3K |
| 69210 | <1% | 703 | $3K | |
| 59025 | Fetal non-stress test | <1% | 172 | $3K |
| 91035 | <1% | 54 | $3K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 172 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 150 | $3K |
| 92567 | <1% | 409 | $3K | |
| 99223 | Prolong inpt eval add15 m | <1% | 67 | $3K |
| 93227 | <1% | 184 | $3K | |
| 99173 | <1% | 1,136 | $2K | |
| 11720 | <1% | 1,014 | $2K | |
| 52000 | <1% | 52 | $2K | |
| 73620 | <1% | 546 | $2K | |
| 92587 | <1% | 360 | $2K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 88 | $2K |
| 30140 | <1% | 15 | $2K | |
| 93016 | <1% | 176 | $2K | |
| 51741 | <1% | 730 | $2K | |
| 11721 | <1% | 335 | $2K | |
| 94060 | <1% | 158 | $2K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 92 | $2K |
| 95117 | <1% | 215 | $1K | |
| 93018 | <1% | 190 | $1K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 29 | $1K |
| 99188 | <1% | 39 | $1K | |
| H1000 | Prenatal care, at-risk assessment | <1% | 14 | $1K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 55 | $1K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 46 | $1K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 29 | $1K |
| 92551 | <1% | 639 | $1K | |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | <1% | 159 | $1K |
| 90670 | <1% | 1,329 | $1K | |
| 90461 | <1% | 3,904 | $911.65 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 173 | $828.77 |
| 99442 | <1% | 460 | $698.44 | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 69 | $567.06 |
| 94727 | <1% | 156 | $510.86 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 73 | $466.78 |
| 94729 | <1% | 155 | $422.71 | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 17 | $416.89 |
| 99439 | <1% | 64 | $415.12 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 82 | $361.56 |
| 73630 | <1% | 80 | $352.18 | |
| 95024 | <1% | 14 | $337.99 | |
| 99490 | Ccm add 20min | <1% | 173 | $313.63 |
| 99217 | <1% | 18 | $312.25 | |
| 93285 | <1% | 14 | $265.02 | |
| 99177 | <1% | 55 | $258.54 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 277 | $220.54 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 17 | $168.01 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 27 | $160.22 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 214 | $158.20 |
| 95886 | <1% | 14 | $146.10 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 230 | $113.20 |
| 93294 | <1% | 20 | $104.51 | |
| 90686 | <1% | 498 | $52.46 | |
| 90698 | <1% | 301 | $35.45 | |
| 90648 | <1% | 1,004 | $27.33 | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 617 | $18.91 |
| 90744 | <1% | 41 | $10.00 | |
| 90680 | <1% | 273 | $10.00 | |
| 81003 | <1% | 15 | $8.11 | |
| 36416 | <1% | 14 | $3.81 | |
| 99024 | <1% | 2,043 | $0.01 | |
| 1123F | 0% | 973 | $0.00 | |
| 1111F | 0% | 30,683 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 6,102 | $0.00 |
| 4000F | 0% | 502 | $0.00 | |
| 1000F | 0% | 272 | $0.00 | |
| 90723 | 0% | 500 | $0.00 | |
| 90656 | 0% | 68 | $0.00 | |
| 90677 | 0% | 192 | $0.00 | |
| 3044F | 0% | 51 | $0.00 | |
| 90716 | 0% | 12 | $0.00 | |
| 3079F | 0% | 79 | $0.00 | |
| 3074F | 0% | 316 | $0.00 | |
| 90696 | 0% | 13 | $0.00 | |
| 3008F | 0% | 61 | $0.00 | |
| 2014F | 0% | 21,503 | $0.00 | |
| 3725F | 0% | 16,996 | $0.00 | |
| 4004F | 0% | 1,165 | $0.00 | |
| 3078F | 0% | 640 | $0.00 | |
| 1124F | 0% | 383 | $0.00 | |
| 1494F | 0% | 117 | $0.00 | |
| 3288F | 0% | 442 | $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% | 422 | $0.00 |
| 90633 | 0% | 196 | $0.00 | |
| G8539 | Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment | 0% | 257 | $0.00 |
| 4013F | 0% | 27 | $0.00 | |
| 2028F | 0% | 13 | $0.00 | |
| 90681 | 0% | 35 | $0.00 | |
| 3077F | 0% | 13 | $0.00 | |
| 90707 | 0% | 12 | $0.00 | |
| 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) | 0% | 13 | $0.00 |
| 90710 | 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 officialO'BRIEN, DANIELLE (CFO)
| Provider | Location | Paid |
|---|---|---|
| Knox Community Hospital | Mount Vernon, OH | $29.19M |
| Knox Community Hospital | Mount Vernon, OH | $113K |
| Knox Community Hospital | Mount Vernon, OH | $31K |
| Knox Community Hospital | Mount Vernon, OH | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.