Physician
Mountaineer Family Medicine, INC.
Mountaineer Family Medicine, INC. was paid $19.54M by Medicaid between Jan 2018 and Dec 2024, across 67 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.
33Billing provider infoMOUNTAINEER FAMILY MEDICINE, INC.
CHARLESTON, WV 25309
CHARLESTON, WV 25309
33aNPI1295874436assigned 02/05/2007
33bProvider typeFamily Medicine Physician
28Total paid$19.54M
24GClaims494,711
24DCodes billed67
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in West Virginia
Rank by total paid#1 of 202
Median peer was paid$172K
This provider vs. median114×
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 | 22,197 | $3.26M | |
| 2019 | 14,309 | $1.42M | |
| 2020 | 103,495 | $4.35M | |
| 2021 | 182,703 | $3.68M | |
| 2022 | 75,983 | $2.46M | |
| 2023 | 50,390 | $2.23M | |
| 2024incomplete | 45,634 | $2.14M |
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 | 27% | 110,895 | 48,995 | $5.26M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 15% | 52,585 | 23,496 | $2.99M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | 14% | 30,945 | 13,887 | $2.71M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 6.3% | 31,027 | 19,569 | $1.22M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 6.2% | 26,273 | 15,351 | $1.22M |
| 82075 | 6.0% | 50,871 | 19,688 | $1.17M | |
| 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 | 4.5% | 11,950 | 8,627 | $874K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 3.5% | 7,537 | 5,567 | $677K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | 2.2% | 1,770 | 885 | $435K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.2% | 14,452 | 9,125 | $433K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 2.2% | 5,627 | 2,706 | $421K |
| 80305 | 1.4% | 36,705 | 17,114 | $276K |
55 more codes
| 99407 | 1.1% | 21,255 | $208K | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 6,056 | $190K |
| 99401 | <1% | 4,704 | $157K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 2,917 | $125K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 2,324 | $122K |
| 99406 | <1% | 4,665 | $121K | |
| 99205 | Prolong outpt/office vis | <1% | 1,725 | $121K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 3,346 | $102K |
| 99408 | <1% | 16,605 | $92K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 1,186 | $77K |
| 99385 | <1% | 1,649 | $68K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 1,100 | $61K |
| Q3014 | Telehealth originating site facility fee | <1% | 4,217 | $61K |
| 99386 | <1% | 1,444 | $58K | |
| 81025 | <1% | 2,152 | $54K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 6,733 | $46K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 432 | $38K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 337 | $32K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 296 | $18K |
| H0031 | Mental health assessment, by non-physician | <1% | 267 | $13K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 409 | $12K |
| 93000 | <1% | 1,598 | $11K | |
| 76942 | <1% | 40 | $9K | |
| 96127 | <1% | 3,632 | $8K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 84 | $7K |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 5,568 | $7K |
| 80306 | <1% | 2,048 | $7K | |
| 86328 | <1% | 298 | $6K | |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | <1% | 383 | $6K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 112 | $3K |
| 99442 | <1% | 5,896 | $3K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 2,497 | $2K |
| 99345 | Prolong home eval add 15m | <1% | 62 | $2K |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | <1% | 477 | $2K |
| 99348 | <1% | 101 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,066 | $1K |
| 99347 | <1% | 129 | $705.90 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 51 | $628.90 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 45 | $547.21 |
| 99441 | <1% | 963 | $416.30 | |
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | <1% | 16 | $372.17 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 56 | $198.47 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 1,096 | $187.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 18 | $123.48 |
| 81003 | <1% | 116 | $67.76 | |
| 82962 | <1% | 16 | $36.45 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 24 | $31.48 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 104 | $9.58 |
| 99443 | 0% | 43 | $0.00 | |
| J3490 | Unclassified drugs | 0% | 50 | $0.00 |
| 99358 | Prolong nursin fac eval 15m | 0% | 135 | $0.00 |
| 80354 | 0% | 2,194 | $0.00 | |
| 98960 | 0% | 1,227 | $0.00 | |
| 99483 | Prolong outpt/office vis | 0% | 95 | $0.00 |
| J0735 | Injection, clonidine hydrochloride, 1 mg | 0% | 15 | $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 officialKALOU, MOHAMAD (OWNER)