Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

COMMUNITY MEDICAL ASSOCIATES, INC.

NPI: 1245312503 · LOUISVILLE, KY 40208 · Clinical Social Worker · NPI assigned 10/19/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official GAST, SHELLEY controls 20+ related entities in our dataset. Read more

$957K
Total Medicaid Paid
59,804
Total Claims
54,877
Beneficiaries
41
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGAST, SHELLEY (VP MANAGED CARE)
NPI Enumeration Date10/19/2006

Related Entities

Other providers sharing the same authorized official: GAST, SHELLEY

ProviderCityStateTotal Paid
NORTON HOSPITALS INC LOUISVILLE KY $419.58M
NORTON HOSPITALS, INC LOUISVILLE KY $299.00M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $135.33M
NORTON CHILDRENS MEDICAL GROUP, LLC LOUISVILLE KY $107.36M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $48.97M
NORTON CLARK HOSPITAL, LLC JEFFERSONVILLE IN $19.62M
NORTON - KINGS DAUGHTERS HEALTH INC MADISON IN $11.81M
NORTON SCOTT HOSPITAL, LLC SCOTTSBURG IN $9.17M
NORTON CLARK PHYSICIAN PRACTICES, LLC CLARKSVILLE IN $7.07M
NORTON HOSPITALS INC LOUISVILLE KY $3.38M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $1.21M
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $1.15M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $808K
NORTON SCOTT HOSPITAL, LLC SCOTTSBURG IN $560K
NORTON HOSPITALS, INC LOUISVILLE KY $438K
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $357K
NORTON CLARK PHYSICIAN PRACTICES, LLC SELLERSBURG IN $273K
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $260K
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $238K
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $189K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 11,687 $124K
2019 9,471 $81K
2020 7,982 $79K
2021 10,085 $199K
2022 8,524 $177K
2023 6,448 $160K
2024 5,607 $137K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 12,368 11,386 $430K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 14,991 13,748 $321K
90460 Immunization administration through 18 years of age via any route, first or only component 2,263 2,165 $27K
36415 Collection of venous blood by venipuncture 10,182 9,005 $21K
83036 Hemoglobin; glycosylated (A1C) 3,078 2,811 $17K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 3,215 2,941 $16K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 272 258 $15K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 466 412 $14K
90686 1,931 1,851 $13K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,372 1,309 $13K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 100 91 $12K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 311 308 $11K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 143 138 $8K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 541 515 $7K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 152 147 $5K
81025 1,246 1,162 $5K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 144 131 $4K
81003 3,998 3,661 $3K
90677 17 17 $3K
90792 Psychiatric diagnostic evaluation with medical services 98 56 $3K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 126 121 $2K
90632 58 55 $1K
90656 99 97 $1K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 51 51 $641.43
90715 59 57 $488.39
69210 49 31 $434.78
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 27 24 $370.12
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 14 14 $235.59
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 59 28 $195.42
36416 138 133 $140.91
90461 189 185 $118.51
90791 Psychiatric diagnostic evaluation 33 13 $97.26
90633 216 213 $81.81
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 34 31 $80.20
90688 15 14 $50.20
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 70 65 $15.70
G0008 Administration of influenza virus vaccine 42 38 $7.19
3008F 1,295 1,259 $1.17
2014F 314 309 $0.35
90734 16 15 $0.00
1111F 12 12 $0.00