Behavioral
ST. Claire Medical Center, INC
ST. Claire Medical Center, INC was paid $3.32M by Medicaid between Jan 2018 and Dec 2024, across 66 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 47% of everything it billed.
33Billing provider infoST. CLAIRE MEDICAL CENTER, INC
MOREHEAD, KY 40351
MOREHEAD, KY 40351
33aNPI1326009044assigned 03/31/2006
33bProvider typeClinical Social Worker
28Total paid$3.32M
24GClaims114,763
24DCodes billed66
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Kentucky
Rank by total paid#19 of 275
Median peer was paid$57K
This provider vs. median58×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official LLOYD, DONALD controls 20+ related entities in our dataset. Read more
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 | 9,304 | $293K | |
| 2019 | 9,010 | $299K | |
| 2020 | 13,033 | $471K | |
| 2021 | 31,256 | $832K | |
| 2022 | 16,878 | $563K | |
| 2023 | 18,368 | $493K | |
| 2024incomplete | 16,914 | $367K |
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 | 47% | 51,159 | 44,444 | $1.57M |
| 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 | 39% | 29,022 | 25,972 | $1.31M |
| 0012A | 1.8% | 2,282 | 2,135 | $59K | |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.6% | 1,831 | 1,411 | $53K |
| 0011A | 1.5% | 2,348 | 2,250 | $50K | |
| 0002A | <1% | 643 | 606 | $23K | |
| 0013A | <1% | 789 | 757 | $20K | |
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring | <1% | 49 | 47 | $20K |
| 0001A | <1% | 533 | 508 | $19K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 616 | 561 | $18K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 382 | 316 | $15K |
| 99442 | <1% | 318 | 289 | $15K |
54 more codes
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 276 | $14K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 481 | $14K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 213 | $14K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 482 | $12K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 170 | $11K |
| 99441 | <1% | 372 | $10K | |
| M0222 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring | <1% | 69 | $9K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 506 | $9K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 151 | $8K |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | <1% | 17 | $7K |
| 0071A | <1% | 167 | $6K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 192 | $6K |
| 0072A | <1% | 127 | $5K | |
| 0003A | <1% | 128 | $5K | |
| 99385 | <1% | 74 | $3K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 37 | $3K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 120 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 73 | $2K |
| 0134A | <1% | 67 | $2K | |
| 99386 | <1% | 28 | $1K | |
| 0124A | <1% | 60 | $1K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 21 | $1K |
| D1110 | Prophylaxis - adult | <1% | 18 | $832.50 |
| 99406 | <1% | 116 | $768.06 | |
| 98926 | <1% | 26 | $737.37 | |
| D0330 | Panoramic radiographic image | <1% | 16 | $600.60 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 17 | $557.77 |
| 0064A | <1% | 13 | $372.00 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 39 | $278.77 |
| 99307 | <1% | 26 | $243.80 | |
| D0272 | Bitewings - two radiographic images | <1% | 14 | $222.25 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 16 | $126.57 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 14 | $90.86 |
| 36415 | Collection of venous blood by venipuncture | <1% | 25 | $61.77 |
| 90633 | <1% | 170 | $29.55 | |
| 1126F | <1% | 5,329 | $22.08 | |
| 1125F | <1% | 2,858 | $11.63 | |
| 3077F | <1% | 1,411 | $5.82 | |
| 3074F | <1% | 1,194 | $5.57 | |
| 3079F | <1% | 963 | $4.34 | |
| 3080F | <1% | 851 | $3.79 | |
| 3078F | <1% | 867 | $3.79 | |
| 3044F | <1% | 648 | $3.21 | |
| 3075F | <1% | 264 | $1.35 | |
| Q0222 | Injection, bebtelovimab, 175 mg | <1% | 69 | $0.21 |
| 3046F | <1% | 29 | $0.11 | |
| 3051F | <1% | 14 | $0.05 | |
| 91307 | 0% | 312 | $0.00 | |
| 91301 | 0% | 4,122 | $0.00 | |
| Q0247 | Injection, sotrovimab, 500 mg | 0% | 47 | $0.00 |
| 91312 | 0% | 57 | $0.00 | |
| 91313 | 0% | 58 | $0.00 | |
| 91300 | 0% | 1,339 | $0.00 | |
| Q0245 | Injection, bamlanivimab and etesevimab, 2100 mg | 0% | 18 | $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 officialLLOYD, DONALD (PRESIDENT/CEO)
| Provider | Location | Paid |
|---|---|---|
| ST Claire Medical Center INC | Morehead, KY | $71.27M |
| ST Claire Medical Center INC. | Morehead, KY | $4.05M |
| ST Claire Medical Center, INC., | Morehead, KY | $3.31M |
| ST Claire Medical Center, INC | Morehead, KY | $3.29M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.11M |
| ST Claire Medical Center, INC., | Morehead, KY | $2.42M |
| ST. Claire Medical Center | Morehead, KY | $2.40M |
| ST. Claire Medical Center, INC. | Morehead, KY | $2.09M |
| ST Claire Regional Radiology Physicians Services | Morehead, KY | $1.83M |
| ST Claire Medical Center, INC., | Morehead, KY | $1.46M |
| ST. Claire Medical Center,inc | Olive Hill, KY | $1.13M |
| ST. Claire Medical Center, INC | Owingsville, KY | $964K |
| ST. Claire Medical Center,inc | Sandy Hook, KY | $948K |
| ST. Claire Medical Center, INC | Frenchburg, KY | $877K |
| ST Claire Medical Center, INC | Morehead, KY | $760K |
| ST. Claire Medical Center, INC | Morehead, KY | $672K |
| ST. Claire Medical Center, INC. | Morehead, KY | $411K |
| ST. Claire Medical Center INC. | Morehead, KY | $371K |
| ST Claire Medical Center INC. | Morehead, KY | $115K |
| ST. Claire Medical Center, INC. | Morehead, KY | $20K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.