NP / PA
Somerset Medical Group PLLC
Somerset Medical Group PLLC was paid $516K by Medicaid between Jan 2018 and Nov 2024, across 36 billing codes. Its largest line is 99233, hospital visit by a doctor, follow-up day (complex) — 52% of everything it billed.
33Billing provider infoSOMERSET MEDICAL GROUP PLLC
SOMERSET, KY 42503
SOMERSET, KY 42503
33aNPI1235242223assigned 08/16/2006
33bProvider typePhysician Assistant
28Total paid$516K
24GClaims29,787
24DCodes billed36
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Physician Assistant providers in Kentucky
Rank by total paid#73 of 214
Median peer was paid$134K
This provider vs. median3.8×
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 | 2,147 | $42K | |
| 2019 | 1,583 | $30K | |
| 2020 | 1,269 | $26K | |
| 2021 | 8,994 | $112K | |
| 2022 | 6,788 | $140K | |
| 2023 | 6,136 | $97K | |
| 2024incomplete | 2,870 | $69K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 52% | 17,170 | 2,049 | $266K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 2,559 | 2,212 | $84K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 7.4% | 1,773 | 133 | $38K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 6.0% | 2,455 | 381 | $31K |
| 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 | 5.9% | 907 | 754 | $30K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.1% | 296 | 258 | $16K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 2.0% | 566 | 466 | $10K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.8% | 748 | 350 | $9K |
| 99443 | <1% | 84 | 70 | $4K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 199 | 193 | $3K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 122 | 96 | $3K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 243 | 235 | $2K |
24 more codes
| 71046 | Radiologic examination, chest; 2 views | <1% | 136 | $2K |
| 99441 | <1% | 66 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 211 | $2K |
| 99490 | Ccm add 20min | <1% | 335 | $2K |
| 80061 | Lipid panel | <1% | 227 | $2K |
| 99223 | Prolong inpt eval add15 m | <1% | 36 | $1K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 325 | $1K |
| 36415 | Collection of venous blood by venipuncture | <1% | 429 | $1K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 44 | $929.39 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 17 | $875.56 |
| 99442 | <1% | 15 | $872.30 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 43 | $870.24 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 48 | $753.04 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 127 | $507.83 |
| 80076 | <1% | 83 | $349.97 | |
| 84439 | <1% | 67 | $314.59 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 13 | $58.65 |
| 80053 | Comprehensive metabolic panel | <1% | 12 | $52.94 |
| 96127 | <1% | 15 | $46.32 | |
| 81002 | <1% | 45 | $17.68 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 14 | $12.36 |
| 99000 | 0% | 23 | $0.00 | |
| 888888 | 0% | 83 | $0.00 | |
| 99072 | 0% | 251 | $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 officialCHERRY, DONALD (OWNER)