Appalachian Orthopedic & Spine CTR LLC

Appalachian Orthopedic & Spine CTR LLC was paid $154K by Medicaid between Jan 2018 and Nov 2024, across 11 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.

33Billing provider infoAPPALACHIAN ORTHOPEDIC & SPINE CTR LLC
HAZARD, KY 41701

33aNPI1235232315assigned 09/06/2006

33bProvider typeOrthopaedic Surgery Physician

28Total paid$154K

24GClaims4,976

24DCodes billed11

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Orthopaedic Surgery Physician providers in Kentucky

Rank by total paid#7 of 23

Median peer was paid$54K

This provider vs. median2.8×

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	1,735	$42K
2019	1,720	$55K
2020	281	$12K
2021	75	$4K
2022	368	$15K
2023	514	$17K
2024incomplete	283	$10K

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	28%	1,582	1,425	$43K
99222	Initial hospital care, per day, moderate complexity	17%	631	500	$26K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	13%	470	397	$21K
99243		13%	257	251	$20K
20610		12%	570	473	$18K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	8.8%	610	229	$14K
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	5.2%	176	166	$8K
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%	33	33	$3K
99244	Office or other outpatient consultation, moderate to high complexity	1.1%	15	15	$2K
J1030	Injection, methylprednisolone acetate, 40 mg	<1%	618	546	$603.17
A4590	Special casting material (e.g., fiberglass)	<1%	14	12	$165.39

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 officialSHARMA, MUKUT (MD OWNER SOLO PRACTICE)