Physician
Clemente V. Zulueta, JR., MD, PLLC
Clemente V. Zulueta, JR., MD, PLLC was paid $2.00M by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 44% of everything it billed.
33Billing provider infoCLEMENTE V. ZULUETA, JR., MD, PLLC
JACKSON, KY 41339
JACKSON, KY 41339
33aNPI1275543175assigned 08/09/2006
33bProvider typeEndocrinology, Diabetes & Metabolism Physician
28Total paid$2.00M
24GClaims58,022
24DCodes billed15
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Endocrinology, Diabetes & Metabolism Physician providers in Kentucky
Rank by total paid#1 of 15
Median peer was paid$17K
This provider vs. median120×
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 | 8,133 | $247K | |
| 2019 | 11,275 | $337K | |
| 2020 | 11,749 | $385K | |
| 2021 | 9,893 | $325K | |
| 2022 | 5,486 | $226K | |
| 2023 | 5,840 | $259K | |
| 2024incomplete | 5,646 | $223K |
Box 24 · Service lines
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 | 44% | 20,869 | 18,414 | $875K |
| 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 | 33% | 16,360 | 14,350 | $667K |
| 80305 | 6.7% | 13,157 | 12,579 | $135K | |
| 99497 | 5.9% | 2,093 | 2,024 | $118K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 5.1% | 1,049 | 1,030 | $101K |
| 99490 | Ccm add 20min | 1.6% | 1,077 | 1,022 | $31K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.3% | 268 | 260 | $26K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.1% | 279 | 270 | $22K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 120 | 119 | $14K |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 1,551 | 1,228 | $5K |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 668 | 422 | $2K |
| 99406 | <1% | 226 | 216 | $2K |
3 more codes
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 114 | $2K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 133 | $900.76 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 58 | $58.50 |
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 officialZULUETA, CLEMENTE (OWNER)