Physician
Pine Mountain Clinic PSC
Pine Mountain Clinic PSC was paid $1.16M by Medicaid between Jan 2018 and Sep 2023, across 39 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 58% of everything it billed.
33Billing provider infoPINE MOUNTAIN CLINIC PSC
PINEVILLE, KY 40977
PINEVILLE, KY 40977
33aNPI1205054327assigned 04/23/2007
33bProvider typeInternal Medicine Physician
28Total paid$1.16M
24GClaims52,042
24DCodes billed39
24AFirst – last monthJan 2018 – Sep 2023
Compared with peers
Next to other Internal Medicine Physician providers in Kentucky
Rank by total paid#28 of 231
Median peer was paid$77K
This provider vs. median15×
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 | 16,082 | $361K | |
| 2019 | 14,236 | $313K | |
| 2020 | 11,404 | $255K | |
| 2021 | 5,002 | $107K | |
| 2022 | 3,746 | $85K | |
| 2023 | 1,572 | $39K |
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 | 58% | 22,200 | 19,651 | $673K |
| 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 | 16% | 4,768 | 4,087 | $186K |
| 99442 | 3.6% | 1,238 | 1,147 | $42K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.9% | 5,187 | 3,718 | $33K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.3% | 1,480 | 1,371 | $26K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 2.2% | 1,215 | 548 | $26K |
| 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 | 1.7% | 234 | 206 | $20K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.3% | 620 | 513 | $16K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 1.3% | 421 | 365 | $15K |
| 93000 | 1.2% | 825 | 787 | $14K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.0% | 458 | 424 | $12K |
| 82947 | 1.0% | 5,065 | 4,638 | $12K |
27 more codes
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 1.0% | 294 | $12K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,569 | $10K |
| 87428 | <1% | 174 | $10K | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 756 | $9K |
| 80305 | <1% | 959 | $8K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 165 | $6K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 278 | $5K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 526 | $4K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 80 | $4K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 95 | $2K |
| 99223 | Prolong inpt eval add15 m | <1% | 45 | $2K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,041 | $2K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 34 | $2K |
| 99406 | <1% | 181 | $1K | |
| 82044 | <1% | 384 | $1K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 975 | $1K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 102 | $977.32 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 306 | $663.83 |
| 99318 | <1% | 15 | $650.00 | |
| 82274 | <1% | 47 | $544.78 | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 14 | $448.00 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 45 | $422.91 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 15 | $309.97 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 14 | $250.38 |
| 81003 | <1% | 162 | $79.37 | |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 20 | $64.74 |
| 99000 | <1% | 35 | $3.12 |
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 officialMOHAN, MADHAN (OWNER)