Medicaid Provider Spending

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

PINELAKE PHYSICIAN PRACTICE, LLC

NPI: 1295960532 · MAYFIELD, KY 42066 · Family Medicine Physician · NPI assigned 05/15/2009

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

Authorized official BOWMAN, MONICA controls 20+ related entities in our dataset. Read more

$2.26M
Total Medicaid Paid
151,870
Total Claims
120,356
Beneficiaries
63
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOWMAN, MONICA (SR. DIRECTOR)
NPI Enumeration Date05/15/2009

Related Entities

Other providers sharing the same authorized official: BOWMAN, MONICA

ProviderCityStateTotal Paid
DLP MARQUETTE PHYSICIAN PRACTICES INC MARQUETTE MI $17.80M
CLARK REGIONAL PHYSICIAN PRACTICES, LLC WINCHESTER KY $9.45M
KENTUCKY MSO, LLC GEORGETOWN KY $6.59M
CLARK REGIONAL PHYSICIAN PRACTICES LLC WINCHESTER KY $2.97M
PORTAGE PHYSICIAN PRACTICES INC HANCOCK MI $1.63M
SPRING VIEW PHYSICIAN PRACTICES, LLC LEBANON KY $1.39M
COLORADO PLAINS PHYSICIAN PRACTICES LLC FORT MORGAN CO $1.28M
SPRING VIEW PHYSICIAN PRACTICES, LLC LEBANON KY $1.27M
NORTHWEST ALABAMA EMERGENCY MEDICINE LLC FLORENCE AL $1.24M
DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC HENDERSON NC $897K
BOURBON PHYSICIAN PRACTICE LLC PARIS KY $847K
PORTAGE PHYSICIAN PRACTICES INC. HOUGHTON MI $763K
DLP CONEMAUGH PHYSICIAN PRACTICES LLC ROARING SPRING PA $761K
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC SOMERSET KY $529K
KENTUCKY MSO LLC GEORGETOWN KY $406K
RCCH TRIOS PHYSICIANS LLC KENNEWICK WA $401K
NATIONAL PARK CARDIOLOGY SERVICES, LLC HOT SPRINGS AR $341K
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC SOMERSET KY $331K
KENTUCKY MSO LLC GEORGETOWN KY $282K
BOURBON PHYSICIAN PRACTICE LLC PARIS KY $266K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 14,845 $424K
2019 11,576 $353K
2020 7,708 $260K
2021 10,767 $353K
2022 21,696 $320K
2023 54,166 $301K
2024 31,112 $250K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 31,902 24,035 $1.06M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 13,779 11,732 $612K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 6,825 4,321 $204K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,573 1,348 $91K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 811 742 $54K
90460 Immunization administration through 18 years of age via any route, first or only component 1,708 1,567 $42K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 683 519 $42K
90461 1,101 1,018 $21K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,065 635 $15K
99307 613 611 $14K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 160 149 $13K
90670 717 664 $12K
87428 288 278 $11K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 130 111 $11K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 200 176 $10K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 518 462 $7K
76801 118 105 $7K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 112 86 $5K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 45 43 $5K
81025 878 773 $5K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 281 245 $4K
87807 184 167 $2K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 28 27 $2K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 12 12 $1K
90723 532 509 $1K
90686 244 226 $878.97
90681 220 212 $783.76
81002 1,532 1,041 $780.06
90647 455 432 $630.75
99462 32 27 $595.37
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 54 15 $586.43
87400 105 21 $573.56
99460 14 14 $556.02
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 14 12 $534.73
99238 Hospital discharge day management, 30 minutes or less 12 12 $377.26
97597 29 12 $341.51
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 20 17 $323.86
G0071 Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only 35 32 $246.98
87430 12 12 $183.73
90633 111 109 $183.22
87210 30 24 $165.01
81003 376 232 $134.57
85018 16 16 $37.29
3074F 12,501 9,992 $34.77
3078F 12,034 9,529 $33.63
3008F 16,306 12,886 $15.24
3079F 2,787 2,491 $8.14
3075F 1,470 1,306 $5.01
1159F 10,938 8,970 $4.13
1160F 10,939 8,970 $4.13
3077F 963 858 $2.67
1036F 10,078 7,528 $2.07
1034F 4,279 3,368 $1.02
3080F 394 339 $0.91
1035F 99 79 $0.03
3725F 1,218 1,006 $0.00
0502F 48 33 $0.00
T1015 Clinic visit/encounter, all-inclusive 19 14 $0.00
90671 30 30 $0.00
99024 142 117 $0.00
90688 24 12 $0.00
90698 15 15 $0.00
90744 12 12 $0.00