ST. Claire Medical Center, INC
ST. Claire Medical Center, INC was paid $877K by Medicaid between Jan 2018 and Nov 2024, across 36 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 56% of everything it billed.
FRENCHBURG, KY 40322
Next to other Primary Care Clinic/Center providers in Kentucky
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 4,930 | $110K | |
| 2019 | 6,101 | $157K | |
| 2020 | 4,752 | $134K | |
| 2021 | 5,209 | $131K | |
| 2022 | 5,483 | $122K | |
| 2023 | 5,564 | $121K | |
| 2024incomplete | 4,943 | $101K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 56% | 17,695 | 12,363 | $495K |
| 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 | 26% | 6,025 | 5,185 | $228K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 5.9% | 1,747 | 834 | $51K |
| D0330 | Panoramic radiographic image | 1.3% | 356 | 343 | $12K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.3% | 488 | 462 | $11K |
| 36415 | Collection of venous blood by venipuncture | <1% | 3,648 | 3,226 | $8K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 287 | 270 | $8K |
| 99442 | <1% | 197 | 152 | $8K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 597 | 565 | $8K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 571 | 480 | $7K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 671 | 385 | $6K |
| D0140 | Limited oral evaluation - problem focused | <1% | 194 | 183 | $5K |
24 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 448 | $5K |
| D0272 | Bitewings - two radiographic images | <1% | 328 | $5K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 251 | $5K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 117 | $4K |
| D1110 | Prophylaxis - adult | <1% | 102 | $3K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 50 | $2K |
| 90686 | <1% | 272 | $2K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 280 | $2K |
| 0002A | <1% | 18 | $704.00 | |
| 87428 | <1% | 22 | $661.83 | |
| D1120 | Dental cleaning, child | <1% | 15 | $567.58 |
| D1206 | Topical application of fluoride varnish | <1% | 32 | $393.75 |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 20 | $347.17 |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 16 | $161.29 |
| 81002 | <1% | 188 | $136.25 | |
| Q3014 | Telehealth originating site facility fee | <1% | 14 | $83.24 |
| 90633 | <1% | 71 | $55.20 | |
| 1126F | <1% | 1,559 | $7.85 | |
| 87301 | <1% | 64 | $4.60 | |
| 1125F | <1% | 463 | $2.53 | |
| 3078F | <1% | 74 | $0.22 | |
| 3074F | <1% | 29 | $0.14 | |
| 3077F | <1% | 13 | $0.06 | |
| 91300 | 0% | 60 | $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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| ST Claire Medical Center INC | Morehead, KY | $71.27M |
| ST Claire Medical Center INC. | Morehead, KY | $4.05M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.32M |
| ST Claire Medical Center, INC., | Morehead, KY | $3.31M |
| ST Claire Medical Center, INC | Morehead, KY | $3.29M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.11M |
| ST Claire Medical Center, INC., | Morehead, KY | $2.42M |
| ST. Claire Medical Center | Morehead, KY | $2.40M |
| ST. Claire Medical Center, INC. | Morehead, KY | $2.09M |
| ST Claire Regional Radiology Physicians Services | Morehead, KY | $1.83M |
| ST Claire Medical Center, INC., | Morehead, KY | $1.46M |
| ST. Claire Medical Center,inc | Olive Hill, KY | $1.13M |
| ST. Claire Medical Center, INC | Owingsville, KY | $964K |
| ST. Claire Medical Center,inc | Sandy Hook, KY | $948K |
| ST Claire Medical Center, INC | Morehead, KY | $760K |
| ST. Claire Medical Center, INC | Morehead, KY | $672K |
| ST. Claire Medical Center, INC. | Morehead, KY | $411K |
| ST. Claire Medical Center INC. | Morehead, KY | $371K |
| ST Claire Medical Center INC. | Morehead, KY | $115K |
| ST. Claire Medical Center, INC. | Morehead, KY | $20K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.