Lab
Pioneer Health Group LLC
Pioneer Health Group LLC was paid $20.55M by Medicaid between Jan 2018 and Dec 2024, across 29 billing codes. Its largest line is 80307, Drug test(s), presumptive, any number of drug classes; immunoassay — 56% of everything it billed.
33Billing provider infoPIONEER HEALTH GROUP LLC
LOUISA, KY 41230
LOUISA, KY 41230
33aNPI1235585126assigned 05/10/2016
33bProvider typeClinical Medical Laboratory
28Total paid$20.55M
24GClaims871,409
24DCodes billed29
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in Kentucky
Rank by total paid#9 of 73
Median peer was paid$95K
This provider vs. median216×
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 | 6,173 | $194K | |
| 2019 | 110,712 | $3.04M | |
| 2020 | 159,229 | $4.60M | |
| 2021 | 111,710 | $2.48M | |
| 2022 | 153,996 | $3.41M | |
| 2023 | 175,273 | $3.91M | |
| 2024incomplete | 154,316 | $2.92M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 56% | 299,119 | 95,855 | $11.48M |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 25% | 386,424 | 88,652 | $5.12M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.5% | 46,640 | 26,869 | $1.34M |
| 99484 | 3.7% | 31,767 | 27,451 | $763K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.2% | 6,725 | 5,244 | $252K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 12,863 | 10,590 | $244K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.1% | 3,314 | 2,797 | $227K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 1.0% | 2,921 | 2,062 | $211K |
| 96156 | <1% | 3,849 | 3,557 | $191K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 8,612 | 5,785 | $190K |
| 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 | <1% | 3,882 | 2,553 | $173K |
| 80305 | <1% | 13,427 | 10,492 | $104K |
17 more codes
| 86580 | <1% | 14,094 | $70K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 985 | $62K |
| 81025 | <1% | 12,508 | $58K | |
| 98960 | <1% | 2,049 | $20K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,372 | $12K |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | <1% | 421 | $12K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 558 | $6K |
| 86703 | <1% | 455 | $4K | |
| 99072 | <1% | 12,654 | $4K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 80 | $3K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 738 | $3K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 28 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 81 | $2K |
| 82075 | <1% | 47 | $987.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 76 | $767.39 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 20 | $752.08 |
| 888888 | 0% | 5,700 | $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 officialROBINSON, TIMMY (CEO)
| Provider | Location | Paid |
|---|---|---|
| Addiction Recovery Care LLC | Louisa, KY | $308.96M |
| Addiction Recovery Care LLC | Owingsville, KY | $24.68M |
| Science Hill Family Care | Science Hill, KY | $8.33M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.