Clinic
Cumberland Family Medical Center INC
Cumberland Family Medical Center INC was paid $72.46M by Medicaid between Jan 2018 and Dec 2024, across 206 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 41% of everything it billed.
33Billing provider infoCUMBERLAND FAMILY MEDICAL CENTER INC
BURKESVILLE, KY 42717
BURKESVILLE, KY 42717
33aNPI1306873500assigned 06/26/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$72.46M
24GClaims2,678,733
24DCodes billed206
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Kentucky
Rank by total paid#1 of 37
Median peer was paid$1.29M
This provider vs. median56×
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 | 266,248 | $6.71M | |
| 2019 | 339,531 | $8.07M | |
| 2020 | 289,564 | $8.06M | |
| 2021 | 390,484 | $10.28M | |
| 2022 | 449,128 | $12.50M | |
| 2023 | 500,225 | $14.52M | |
| 2024incomplete | 443,553 | $12.33M |
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 | 41% | 890,614 | 757,098 | $29.59M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 7.8% | 138,622 | 80,343 | $5.67M |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 7.0% | 378,942 | 242,199 | $5.04M |
| T2023 | Targeted case management; per month | 4.2% | 9,465 | 9,114 | $3.04M |
| 87428 | 3.5% | 64,275 | 60,018 | $2.55M | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.9% | 83,918 | 74,901 | $2.09M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.6% | 30,193 | 29,515 | $1.92M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.5% | 33,481 | 30,249 | $1.84M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.3% | 28,391 | 27,434 | $1.68M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.9% | 26,254 | 18,684 | $1.40M |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.8% | 101,638 | 94,727 | $1.31M |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 1.7% | 15,995 | 9,872 | $1.22M |
194 more codes
| 99214 | Doctor's office visit, returning patient (more involved) | 1.5% | 21,680 | $1.11M |
| G0467 | Community health center visit, returning patient | 1.4% | 105,825 | $1.02M |
| D1120 | Dental cleaning, child | 1.3% | 22,588 | $921K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.2% | 12,490 | $835K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 1.1% | 22,094 | $808K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 45,424 | $579K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 27,920 | $574K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 44,133 | $570K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 42,609 | $550K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 17,198 | $548K |
| 90686 | <1% | 29,767 | $478K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 9,678 | $459K |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 14,378 | $377K |
| D0120 | Dental checkup, returning patient | <1% | 16,040 | $355K |
| D1206 | Topical application of fluoride varnish | <1% | 25,318 | $320K |
| 90887 | <1% | 6,675 | $311K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 4,739 | $308K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 3,684 | $305K |
| D1110 | Prophylaxis - adult | <1% | 6,766 | $300K |
| 59025 | Fetal non-stress test | <1% | 9,146 | $241K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 5,643 | $237K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 5,148 | $202K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 2,568 | $185K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 247 | $178K |
| D0140 | Limited oral evaluation - problem focused | <1% | 1,814 | $152K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 2,940 | $149K |
| 99218 | <1% | 3,402 | $139K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 18,932 | $130K |
| 80305 | <1% | 13,163 | $129K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 1,968 | $111K |
| D0274 | Bitewings - four radiographic images | <1% | 4,058 | $106K |
| 87807 | <1% | 9,291 | $106K | |
| 76830 | Ultrasound, transvaginal | <1% | 1,937 | $105K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 1,247 | $90K |
| 99174 | <1% | 6,854 | $90K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 1,952 | $88K |
| 59410 | <1% | 133 | $86K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 1,260 | $82K |
| 76820 | <1% | 1,673 | $68K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 2,194 | $68K |
| 99221 | <1% | 1,439 | $65K | |
| 90671 | <1% | 1,780 | $64K | |
| 90674 | <1% | 3,042 | $60K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 768 | $58K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 1,227 | $55K |
| 95115 | <1% | 5,592 | $54K | |
| 99383 | <1% | 959 | $53K | |
| D1351 | Sealant - per tooth | <1% | 3,359 | $51K |
| 76801 | <1% | 1,015 | $50K | |
| 90688 | <1% | 3,545 | $49K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 926 | $48K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 1,050 | $48K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 2,852 | $44K |
| D0272 | Bitewings - two radiographic images | <1% | 2,437 | $39K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 444 | $34K |
| 90685 | <1% | 2,250 | $33K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 459 | $32K |
| 95117 | <1% | 2,770 | $31K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 2,560 | $30K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,255 | $26K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 2,053 | $25K |
| 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% | 2,192 | $25K |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 2,983 | $24K |
| 90670 | <1% | 17,619 | $24K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 317 | $24K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 2,496 | $23K |
| 99460 | <1% | 536 | $22K | |
| 90633 | <1% | 11,478 | $21K | |
| 81025 | <1% | 3,514 | $21K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 6,536 | $19K |
| 0071A | <1% | 524 | $18K | |
| 0001A | <1% | 538 | $18K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 3,194 | $17K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 235 | $16K |
| 54150 | <1% | 232 | $15K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 4,744 | $14K |
| 99384 | <1% | 221 | $14K | |
| 90734 | <1% | 3,786 | $14K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,498 | $13K |
| 0072A | <1% | 382 | $13K | |
| 0012A | <1% | 421 | $13K | |
| 0002A | <1% | 333 | $11K | |
| 90698 | <1% | 10,657 | $11K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 285 | $11K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 244 | $11K |
| J0561 | Injection, penicillin g benzathine, 100,000 units | <1% | 86 | $11K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 20,569 | $11K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 177 | $10K |
| 0011A | <1% | 466 | $10K | |
| 96137 | <1% | 245 | $10K | |
| G0466 | Community health center visit, new patient | <1% | 1,014 | $10K |
| 76813 | <1% | 170 | $9K | |
| 83655 | <1% | 798 | $9K | |
| 90680 | <1% | 10,927 | $9K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 139 | $8K |
| D4341 | <1% | 485 | $8K | |
| 90697 | <1% | 3,649 | $8K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,176 | $7K |
| D0330 | Panoramic radiographic image | <1% | 208 | $7K |
| 90687 | <1% | 659 | $7K | |
| 99219 | <1% | 164 | $7K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 246 | $6K |
| 96136 | <1% | 270 | $6K | |
| D1330 | <1% | 23,394 | $6K | |
| 99217 | <1% | 125 | $5K | |
| 99235 | <1% | 50 | $5K | |
| 90632 | <1% | 144 | $5K | |
| J1020 | Injection, methylprednisolone acetate, 20 mg | <1% | 893 | $5K |
| 90715 | <1% | 1,470 | $5K | |
| 99381 | <1% | 74 | $5K | |
| 99408 | <1% | 2,645 | $5K | |
| 99173 | <1% | 178 | $5K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 324 | $4K |
| 99462 | <1% | 208 | $4K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 13 | $4K |
| 90839 | <1% | 47 | $4K | |
| 90651 | <1% | 587 | $4K | |
| 90649 | <1% | 1,347 | $3K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 89 | $3K |
| J2010 | Injection, lincomycin hcl, up to 300 mg | <1% | 301 | $3K |
| 81003 | <1% | 7,448 | $3K | |
| 90619 | <1% | 147 | $3K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 46 | $3K |
| H0001 | Alcohol and/or drug assessment | <1% | 43 | $3K |
| D2335 | <1% | 28 | $3K | |
| 90744 | <1% | 3,580 | $3K | |
| 86580 | <1% | 480 | $2K | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 1,746 | $2K |
| 96130 | <1% | 34 | $2K | |
| 90710 | <1% | 516 | $2K | |
| 59430 | <1% | 31 | $2K | |
| 99385 | <1% | 26 | $2K | |
| 96131 | <1% | 33 | $2K | |
| 90716 | <1% | 708 | $2K | |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 150 | $2K |
| 90707 | <1% | 630 | $1K | |
| 99382 | <1% | 29 | $1K | |
| 99224 | <1% | 89 | $1K | |
| D2332 | <1% | 16 | $1K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 15 | $1K |
| 96127 | <1% | 245 | $1K | |
| 90723 | <1% | 1,159 | $848.64 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 195 | $843.68 |
| 90846 | Family psychotherapy without the patient present, 50 minutes | <1% | 15 | $767.87 |
| 86308 | <1% | 125 | $691.98 | |
| 90461 | <1% | 48 | $660.30 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 166 | $633.97 |
| 81000 | <1% | 329 | $616.90 | |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | <1% | 81 | $603.49 |
| 90696 | <1% | 617 | $599.80 | |
| 96138 | <1% | 34 | $594.33 | |
| 93000 | <1% | 40 | $529.32 | |
| 99441 | <1% | 16 | $510.00 | |
| 90620 | <1% | 25 | $491.79 | |
| 0064A | <1% | 21 | $450.00 | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 24 | $351.44 |
| 90672 | <1% | 15 | $319.80 | |
| 90647 | <1% | 95 | $287.44 | |
| 90677 | <1% | 113 | $282.00 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 300 | $217.76 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 361 | $183.63 |
| 90648 | <1% | 921 | $130.23 | |
| 90634 | <1% | 12 | $107.05 | |
| D9420 | <1% | 109 | $52.00 | |
| J0290 | Injection, ampicillin sodium, 500 mg | <1% | 18 | $51.02 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 12 | $45.23 |
| 3074F | <1% | 15,465 | $32.59 | |
| 3078F | <1% | 14,405 | $30.05 | |
| 82948 | <1% | 17 | $28.54 | |
| 81002 | <1% | 29 | $10.44 | |
| 3079F | <1% | 3,359 | $9.52 | |
| 3075F | <1% | 1,780 | $4.90 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 202 | $4.82 |
| D0603 | <1% | 17,080 | $2.26 | |
| 3077F | <1% | 386 | $1.25 | |
| 3080F | <1% | 186 | $0.56 | |
| 1159F | <1% | 5,344 | $0.43 | |
| 1160F | <1% | 4,861 | $0.38 | |
| 3044F | <1% | 57 | $0.19 | |
| 1036F | <1% | 17,319 | $0.04 | |
| D1320 | <1% | 94 | $0.03 | |
| D0602 | 0% | 2,234 | $0.00 | |
| 1034F | 0% | 1,450 | $0.00 | |
| D0601 | 0% | 318 | $0.00 | |
| D0604 | 0% | 1,355 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 59 | $0.00 |
| 99308 | Subsequent nursing facility care, per day, straightforward | 0% | 48 | $0.00 |
| 4004F | 0% | 1,199 | $0.00 | |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | 0% | 1,419 | $0.00 |
| 888888 | 0% | 658 | $0.00 | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | 0% | 18 | $0.00 |
| 90662 | 0% | 22 | $0.00 | |
| D9430 | 0% | 15 | $0.00 | |
| 90621 | 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 officialLOY, ERIC (CEO)
| Provider | Location | Paid |
|---|---|---|
| Cumberland Family Medical Center INC | Albany, KY | $2K |
| Cumberland Family Medical Center INC | Gamaliel, KY | $1K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.