Southfork Medical Clinic PLLC
Southfork Medical Clinic PLLC was paid $1.64M by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 62% of everything it billed.
33Billing provider infoSOUTHFORK MEDICAL CLINIC PLLC
WHITLEY CITY, KY 42653
WHITLEY CITY, KY 42653
33aNPI1295718757assigned 11/29/2005
33bProvider typeSpecialist
28Total paid$1.64M
24GClaims95,905
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in Kentucky
Rank by total paid#8 of 73
Median peer was paid$107K
This provider vs. median15×
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 | 15,286 | $287K | |
| 2019 | 15,236 | $264K | |
| 2020 | 11,455 | $186K | |
| 2021 | 13,825 | $241K | |
| 2022 | 16,287 | $285K | |
| 2023 | 14,330 | $225K | |
| 2024incomplete | 9,486 | $149K |
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 | 62% | 38,473 | 30,313 | $1.02M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 15% | 12,410 | 10,296 | $247K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 7.2% | 10,281 | 8,556 | $118K |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 6.2% | 2,922 | 2,651 | $101K |
| 85027 | 3.6% | 11,522 | 10,439 | $59K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.5% | 1,726 | 1,655 | $24K |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,237 | 4,689 | $13K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 821 | 391 | $10K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 270 | 265 | $10K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,705 | 2,227 | $9K |
| 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 | <1% | 149 | 147 | $8K |
| 87430 | <1% | 352 | 334 | $5K |
18 more codes
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 6,185 | $4K |
| Q3014 | Telehealth originating site facility fee | <1% | 461 | $3K |
| 81001 | <1% | 1,142 | $2K | |
| 99201 | <1% | 16 | $1K | |
| 90674 | <1% | 65 | $920.64 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 139 | $833.71 |
| J3300 | Injection, triamcinolone acetonide, preservative free, 1 mg | <1% | 144 | $772.40 |
| J2010 | Injection, lincomycin hcl, up to 300 mg | <1% | 36 | $604.11 |
| 90688 | <1% | 25 | $349.14 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 45 | $275.57 |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 31 | $238.99 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 13 | $140.40 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 12 | $50.98 |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 210 | $40.01 |
| 1125F | <1% | 29 | $0.09 | |
| 3074F | 0% | 139 | $0.00 | |
| 3077F | 0% | 107 | $0.00 | |
| 3078F | 0% | 238 | $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 officialPIMENTEL, FRANCIS (MEDICAL DIRECTOR)