Clinic
Pinelake Physician Practice LLC
Pinelake Physician Practice LLC was paid $263K by Medicaid between Jan 2018 and Dec 2024, across 38 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 64% of everything it billed.
33Billing provider infoPINELAKE PHYSICIAN PRACTICE LLC
HICKMAN, KY 42050
HICKMAN, KY 42050
33aNPI1205494085assigned 06/05/2019
33bProvider typeRural Health Clinic/Center
28Total paid$263K
24GClaims19,967
24DCodes billed38
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Kentucky
Rank by total paid#168 of 265
Median peer was paid$400K
This provider vs. median0.7×
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 DILLON, TERRANCE 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 | 1,680 | $42K | |
| 2019 | 3,491 | $77K | |
| 2020 | 2,211 | $27K | |
| 2021 | 1,239 | $15K | |
| 2022 | 5,126 | $57K | |
| 2023 | 3,931 | $26K | |
| 2024incomplete | 2,289 | $18K |
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 | 64% | 7,378 | 5,682 | $167K |
| 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 | 13% | 731 | 613 | $33K |
| 87428 | 10% | 544 | 479 | $26K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 4.3% | 1,019 | 703 | $11K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.8% | 437 | 208 | $5K |
| 36415 | Collection of venous blood by venipuncture | 1.5% | 957 | 719 | $4K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 441 | 352 | $4K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 188 | 161 | $3K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 75 | 65 | $2K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 48 | 46 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 29 | 24 | $841.52 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 235 | 191 | $743.91 |
26 more codes
| 87430 | <1% | 109 | $686.98 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 13 | $665.52 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 56 | $486.72 |
| 90461 | <1% | 24 | $325.36 | |
| 99307 | <1% | 15 | $306.00 | |
| 90756 | <1% | 33 | $215.36 | |
| 97597 | <1% | 29 | $201.01 | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 15 | $174.80 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 295 | $160.87 |
| 99442 | <1% | 22 | $154.27 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 73 | $103.60 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 26 | $64.13 |
| 81002 | <1% | 14 | $11.87 | |
| 3074F | <1% | 802 | $1.68 | |
| 3008F | <1% | 1,507 | $1.60 | |
| 3078F | <1% | 723 | $1.47 | |
| 3079F | <1% | 279 | $0.77 | |
| 3077F | <1% | 181 | $0.60 | |
| 1160F | <1% | 1,065 | $0.40 | |
| 1159F | <1% | 1,066 | $0.40 | |
| 3075F | <1% | 81 | $0.25 | |
| 3080F | <1% | 86 | $0.21 | |
| 1036F | <1% | 600 | $0.18 | |
| 1034F | <1% | 525 | $0.02 | |
| 99000 | 0% | 48 | $0.00 | |
| 3725F | 0% | 198 | $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 officialDILLON, TERRANCE (ASSISTANT SECRETARY)
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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.