Behavioral
Community Medical Associates, INC.
Community Medical Associates, INC. was paid $957K by Medicaid between Jan 2018 and Dec 2024, across 41 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 45% of everything it billed.
33Billing provider infoCOMMUNITY MEDICAL ASSOCIATES, INC.
LOUISVILLE, KY 40208
LOUISVILLE, KY 40208
33aNPI1245312503assigned 10/19/2006
33bProvider typeClinical Social Worker
28Total paid$957K
24GClaims59,804
24DCodes billed41
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Kentucky
Rank by total paid#38 of 275
Median peer was paid$57K
This provider vs. median17×
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 GAST, SHELLEY 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 | 11,687 | $124K | |
| 2019 | 9,471 | $81K | |
| 2020 | 7,982 | $79K | |
| 2021 | 10,085 | $199K | |
| 2022 | 8,524 | $177K | |
| 2023 | 6,448 | $160K | |
| 2024incomplete | 5,607 | $137K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 45% | 12,368 | 11,386 | $430K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 34% | 14,991 | 13,748 | $321K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.8% | 2,263 | 2,165 | $27K |
| 36415 | Collection of venous blood by venipuncture | 2.2% | 10,182 | 9,005 | $21K |
| 83036 | Hemoglobin; glycosylated (A1C) | 1.7% | 3,078 | 2,811 | $17K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.7% | 3,215 | 2,941 | $16K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.5% | 272 | 258 | $15K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.4% | 466 | 412 | $14K |
| 90686 | 1.4% | 1,931 | 1,851 | $13K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.4% | 1,372 | 1,309 | $13K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 1.3% | 100 | 91 | $12K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.2% | 311 | 308 | $11K |
29 more codes
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 143 | $8K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 541 | $7K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 152 | $5K |
| 81025 | <1% | 1,246 | $5K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 144 | $4K |
| 81003 | <1% | 3,998 | $3K | |
| 90677 | <1% | 17 | $3K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 98 | $3K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 126 | $2K |
| 90632 | <1% | 58 | $1K | |
| 90656 | <1% | 99 | $1K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 51 | $641.43 |
| 90715 | <1% | 59 | $488.39 | |
| 69210 | <1% | 49 | $434.78 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 27 | $370.12 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 14 | $235.59 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 59 | $195.42 |
| 36416 | <1% | 138 | $140.91 | |
| 90461 | <1% | 189 | $118.51 | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 33 | $97.26 |
| 90633 | <1% | 216 | $81.81 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 34 | $80.20 |
| 90688 | <1% | 15 | $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) | <1% | 70 | $15.70 |
| G0008 | Administration of influenza virus vaccine | <1% | 42 | $7.19 |
| 3008F | <1% | 1,295 | $1.17 | |
| 2014F | <1% | 314 | $0.35 | |
| 90734 | 0% | 16 | $0.00 | |
| 1111F | 0% | 12 | $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 officialGAST, SHELLEY (VP MANAGED CARE)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.