Medicaid Provider Spending

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

COMMUNITY CARE OF WEST VIRGINIA, INC.

NPI: 1255507810 · BUCKHANNON, WV 26201 · Federally Qualified Health Center (FQHC) · NPI assigned 05/05/2008

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

Authorized official SIMON, RICHARD controls 11+ related entities in our dataset. Read more

$6.32M
Total Medicaid Paid
89,462
Total Claims
74,550
Beneficiaries
48
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSIMON, RICHARD (CEO)
Parent OrganizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
NPI Enumeration Date05/05/2008

Related Entities

Other providers sharing the same authorized official: SIMON, RICHARD

ProviderCityStateTotal Paid
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $606K
COMMUNITY CARE OF WEST VIRGINIA, INC. SUTTON WV $324K
COMMUNITY CARE OF WEST VIRGINIA, INC. SUTTON WV $156K
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $129K
COMMUNITY CARE OF WEST VIRGINIA, INC. GREEN BANK WV $126K
COMMUNITY CARE OF WEST VIRGINIA, INC. DUNMORE WV $95K
COMMUNITY CARE OF WEST VIRGINIA, INC. GREEN BANK WV $16K
COMMUNITY CARE OF WEST VIRGINIA, INC. FRENCH CREEK WV $13K
COMMUNITY CARE OF WEST VIRGINIA, INC. LOST CREEK WV $6K
COMMUNITY CARE OF WEST VIRGINIA, INC. MARLINTON WV $1K
WOLFE-SIMON MEDICAL ASSOCIATES PA CHERRY HILL NJ $599.76

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 11,118 $798K
2019 6,738 $476K
2020 13,341 $693K
2021 15,075 $857K
2022 27,717 $1.95M
2023 9,428 $888K
2024 6,045 $655K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 34,381 27,281 $5.65M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 20,783 17,056 $276K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 2,583 2,333 $85K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,299 3,812 $76K
87428 1,658 1,517 $54K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,851 1,650 $32K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,174 2,817 $28K
90472 Immunization administration, each additional vaccine (list separately) 1,919 1,629 $13K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 888 778 $12K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,474 1,296 $12K
81002 653 606 $12K
90686 1,114 986 $11K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 873 730 $8K
90648 519 491 $6K
90670 463 437 $5K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,340 1,204 $5K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 96 79 $5K
92551 2,121 1,882 $4K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 187 161 $4K
96110 Developmental screening, with scoring and documentation, per standardized instrument 1,923 1,674 $3K
90723 230 214 $3K
90680 160 150 $2K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 292 245 $2K
90474 134 124 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 80 70 $2K
90633 105 90 $1K
81025 30 25 $768.76
90656 74 73 $22.35
3078F 543 482 $0.00
90837 Psychotherapy, 53 minutes with patient 498 207 $0.00
81003 191 141 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 433 348 $0.00
1160F 679 606 $0.00
90672 32 31 $0.00
99173 66 65 $0.00
1159F 679 606 $0.00
90710 30 26 $0.00
90473 33 27 $0.00
99000 1,555 1,441 $0.00
1036F 338 299 $0.00
3074F 616 545 $0.00
87807 214 180 $0.00
90677 38 38 $0.00
90651 16 12 $0.00
1034F 17 16 $0.00
3079F 38 33 $0.00
90696 30 25 $0.00
1035F 12 12 $0.00