Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › KY › Lexington › NPI 1326091448
Physician

Kentucky Medical Services Foundation, INC

Kentucky Medical Services Foundation, INC was paid $110.27M by Medicaid between Jan 2018 and Dec 2024, across 416 billing codes. Its largest line is 99469, Subsequent inpatient neonatal critical care, per day, 28 days or younger — 8.4% of everything it billed.

33Billing provider infoKENTUCKY MEDICAL SERVICES FOUNDATION, INC
LEXINGTON, KY 40517
33aNPI1326091448assigned 05/18/2006
33bProvider typeEmergency Medicine Physician
28Total paid$110.27M
24GClaims2,925,950
24DCodes billed416
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Emergency Medicine Physician providers in Kentucky

Rank by total paid#1 of 91
Median peer was paid$34K
This provider vs. median3,234×

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

$0$1.0M$2.0M2018201920202021202220232024
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
YearClaimsPaid
2018361,128$11.64M
2019375,960$12.92M
2020364,239$13.92M
2021440,781$16.60M
2022459,946$17.30M
2023515,567$20.46M
2024incomplete408,329$17.43M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 8.4% 35,739 8,362 $9.23M
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 7.9% 180,707 162,496 $8.75M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 6.7% 83,555 77,152 $7.43M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 6.3% 111,958 104,920 $6.93M
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 6.0% 230,424 85,647 $6.59M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5.7% 179,670 154,070 $6.23M
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years 5.3% 23,162 4,287 $5.86M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 4.2% 111,043 105,080 $4.61M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 3.3% 93,572 32,450 $3.66M
74177 Computed tomography, abdomen and pelvis; with contrast material 2.5% 47,083 43,218 $2.72M
99244 Office or other outpatient consultation, moderate to high complexity 2.4% 24,856 23,257 $2.67M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 2.3% 37,315 33,278 $2.50M
404 more codes
99480 Subsequent intensive care, per day, low birth weight infant 1.9% 25,409 $2.13M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.6% 40,539 $1.78M
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1.5% 234,808 $1.65M
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1.4% 14,497 $1.54M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1.3% 14,649 $1.44M
71045 Radiologic examination, chest; single view 1.3% 278,943 $1.38M
70450 Computed tomography, head or brain; without contrast material <1% 39,649 $995K
99238 Hospital discharge day management, 30 minutes or less <1% 20,869 $891K
99243 <1% 11,498 $888K
71275 Computed tomographic angiography, chest, with contrast material <1% 23,780 $796K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 5,804 $784K
95720 <1% 6,817 $750K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 16,375 $709K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 9,775 $691K
70496 <1% 14,068 $672K
99204 Doctor's office visit, new patient (more involved) <1% 8,248 $661K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 10,706 $627K
99479 Subsequent intensive care, per day, very low birth weight infant <1% 7,560 $623K
70498 <1% 12,968 $604K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 3,129 $570K
93304 <1% 12,643 $534K
99223 Prolong inpt eval add15 m <1% 6,080 $525K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 9,768 $516K
72125 Computed tomography, cervical spine; without contrast material <1% 14,671 $510K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 12,352 $443K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 20,886 $417K
74018 <1% 79,310 $411K
59025 Fetal non-stress test <1% 15,803 $406K
99203 Doctor's office visit, new patient (routine) <1% 7,059 $404K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 2,593 $390K
99254 <1% 4,508 $378K
95951 <1% 3,441 $377K
71250 <1% 11,476 $376K
99239 Hospital discharge day management, more than 30 minutes <1% 6,983 $372K
70551 Magnetic resonance imaging, brain; without contrast material <1% 6,181 $363K
99245 <1% 2,766 $356K
93325 <1% 28,177 $339K
71046 Radiologic examination, chest; 2 views <1% 45,109 $337K
74174 <1% 5,305 $332K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 6,407 $328K
72131 <1% 9,462 $326K
92134 <1% 19,355 $319K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 2,584 $317K
93975 <1% 5,756 $314K
43264 <1% 1,334 $311K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study <1% 5,222 $305K
74183 <1% 1,896 $286K
72128 <1% 8,331 $285K
90792 Psychiatric diagnostic evaluation with medical services <1% 3,607 $285K
76830 Ultrasound, transvaginal <1% 6,426 $279K
67028 Intravitreal injection of a pharmacologic agent <1% 4,335 $267K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits <1% 2,341 $251K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 4,253 $249K
77067 Screening mammography, bilateral, including computer-aided detection <1% 9,869 $235K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 10,686 $231K
93321 <1% 17,407 $227K
99222 Initial hospital care, per day, moderate complexity <1% 3,164 $222K
76770 <1% 8,418 $220K
01922 <1% 1,494 $210K
73562 <1% 23,860 $202K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 3,414 $196K
99468 <1% 310 $191K
95816 <1% 5,765 $189K
01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery <1% 595 $183K
99417 Prolong home eval add 15m <1% 3,912 $183K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 5,424 $182K
77427 <1% 2,115 $180K
73130 <1% 20,155 $172K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 1,450 $169K
77063 Screening digital breast tomosynthesis, bilateral <1% 8,741 $167K
76642 <1% 7,403 $161K
78815 Positron emission tomography (PET) for limited area imaging <1% 3,196 $160K
76819 Fetal biophysical profile; without non-stress testing <1% 4,872 $158K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials <1% 1,147 $157K
73630 <1% 23,069 $148K
99255 <1% 1,262 $148K
01961 <1% 536 $147K
43274 <1% 969 $140K
76813 <1% 2,571 $137K
31231 <1% 2,553 $135K
73610 <1% 19,994 $125K
93320 <1% 5,505 $124K
93970 <1% 6,858 $124K
92060 <1% 4,697 $121K
93000 <1% 6,070 $119K
73221 <1% 946 $117K
99460 <1% 2,641 $112K
99205 Prolong outpt/office vis <1% 1,021 $112K
73030 <1% 13,552 $109K
77014 <1% 4,217 $105K
92083 <1% 3,291 $105K
00170 Anesthesia for intraoral procedures, including biopsy <1% 951 $104K
94010 <1% 9,901 $102K
95117 <1% 8,071 $96K
73110 <1% 12,735 $95K
92015 Determination of refractive state <1% 9,806 $91K
70486 <1% 2,453 $90K
20611 <1% 1,448 $84K
76801 <1% 1,881 $82K
77066 Tomosynthesis, mammo <1% 2,628 $80K
73590 <1% 14,013 $79K
95806 <1% 819 $77K
76506 <1% 3,320 $77K
31579 <1% 827 $75K
01996 <1% 1,561 $74K
93971 <1% 4,745 $73K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 3,057 $73K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 644 $71K
90935 Hemodialysis procedure with single evaluation by a physician <1% 1,936 $69K
92504 <1% 6,772 $68K
59514 <1% 107 $66K
72100 <1% 6,927 $63K
G6015 Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session <1% 435 $61K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 891 $59K
G6002 Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy <1% 2,890 $57K
95718 <1% 719 $56K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 3,041 $56K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 2,158 $56K
69210 <1% 2,418 $54K
70491 <1% 1,291 $52K
99152 <1% 6,824 $51K
73502 <1% 6,736 $49K
88108 <1% 2,950 $49K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis <1% 186 $49K
73080 <1% 7,608 $48K
31575 <1% 1,162 $47K
73552 <1% 8,566 $47K
77065 Tomosynthesis, mammo <1% 2,007 $47K
74230 <1% 3,288 $44K
76820 <1% 1,879 $43K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) <1% 59 $43K
72040 <1% 4,894 $43K
91200 <1% 3,037 $42K
99051 <1% 7,541 $41K
00126 <1% 550 $41K
73090 <1% 6,953 $39K
76818 <1% 1,264 $39K
29888 <1% 68 $38K
73120 <1% 6,655 $38K
73100 <1% 6,612 $37K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 1,324 $37K
76536 <1% 1,408 $37K
93227 <1% 1,277 $36K
77062 <1% 1,159 $36K
H0049 Alcohol and/or drug screening <1% 2,191 $34K
73700 <1% 1,017 $34K
99253 <1% 599 $33K
72170 <1% 6,247 $31K
93308 <1% 934 $31K
43275 <1% 252 $30K
94060 <1% 1,941 $29K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,698 $29K
64488 <1% 557 $29K
94726 <1% 3,791 $28K
J9035 Injection, bevacizumab, 10 mg <1% 692 $28K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 2,635 $27K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 171 $27K
73560 <1% 4,161 $27K
20610 <1% 737 $26K
36415 Collection of venous blood by venipuncture <1% 6,601 $25K
99462 <1% 1,125 $25K
77080 <1% 1,482 $24K
93923 <1% 1,222 $23K
67311 <1% 96 $22K
83036 Hemoglobin; glycosylated (A1C) <1% 2,594 $22K
77334 <1% 376 $22K
92226 <1% 959 $21K
99242 <1% 386 $21K
95024 <1% 328 $21K
73564 <1% 1,764 $21K
77263 <1% 268 $20K
42830 <1% 219 $20K
94729 <1% 4,044 $19K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) <1% 1,198 $19K
J3590 Unclassified biologics <1% 1,075 $19K
73060 <1% 3,231 $19K
95813 <1% 347 $18K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 630 $18K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 103 $18K
81003 <1% 18,594 $17K
92201 <1% 1,610 $17K
36226 <1% 103 $16K
72192 <1% 615 $16K
36224 <1% 89 $16K
61510 <1% 15 $16K
80305 <1% 1,487 $16K
96127 <1% 3,711 $15K
90686 <1% 1,263 $15K
99241 <1% 485 $14K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 632 $14K
72082 <1% 1,269 $13K
95886 <1% 349 $13K
93976 <1% 406 $13K
95251 <1% 987 $12K
77300 <1% 276 $12K
54161 <1% 106 $11K
90961 <1% 160 $11K
64615 <1% 111 $10K
93241 <1% 54 $10K
72158 <1% 121 $10K
36558 <1% 105 $10K
99418 Prolong nursin fac eval 15m <1% 223 $10K
72197 <1% 107 $9K
99221 <1% 298 $9K
99497 <1% 257 $9K
90750 <1% 41 $9K
72141 <1% 57 $9K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 287 $9K
93248 <1% 584 $8K
64493 <1% 122 $8K
0298T <1% 831 $8K
22842 <1% 36 $8K
77061 <1% 232 $8K
93224 <1% 75 $8K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 124 $8K
22853 <1% 38 $8K
92283 <1% 794 $8K
22614 <1% 21 $8K
77072 <1% 559 $7K
93244 <1% 484 $7K
99217 <1% 154 $7K
72110 <1% 621 $7K
43235 <1% 89 $7K
20936 <1% 61 $7K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 186 $7K
72050 <1% 677 $7K
95782 <1% 76 $7K
76942 <1% 275 $7K
70355 <1% 992 $7K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 169 $7K
88189 <1% 108 $7K
93880 <1% 469 $7K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 1,463 $7K
98927 <1% 266 $7K
71271 <1% 215 $6K
77336 <1% 143 $6K
31628 <1% 67 $6K
73720 <1% 114 $6K
95819 <1% 179 $6K
95885 <1% 352 $6K
62324 <1% 106 $6K
76825 <1% 161 $6K
90678 <1% 23 $6K
72202 <1% 743 $6K
85060 <1% 696 $6K
92133 <1% 261 $6K
81025 <1% 908 $5K
76827 <1% 161 $5K
72070 <1% 568 $5K
76937 <1% 792 $5K
72190 <1% 617 $4K
64494 <1% 119 $4K
99490 Ccm add 20min <1% 411 $4K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 54 $4K
87631 <1% 34 $4K
93454 <1% 33 $4K
99153 Mod sedat endo service >5yrs <1% 1,432 $4K
76982 <1% 201 $4K
73521 <1% 436 $4K
61781 <1% 30 $4K
90715 <1% 119 $4K
73501 <1% 650 $4K
99173 <1% 75 $4K
93018 <1% 289 $3K
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 46 $3K
72156 <1% 39 $3K
75574 <1% 49 $3K
99358 Prolong nursin fac eval 15m <1% 64 $3K
77301 <1% 14 $3K
81002 <1% 4,777 $3K
99385 <1% 78 $3K
98928 <1% 129 $3K
77076 <1% 124 $3K
31571 <1% 24 $3K
11102 <1% 97 $3K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 167 $3K
76882 <1% 216 $3K
98929 <1% 69 $3K
72157 <1% 30 $2K
62323 <1% 43 $2K
90853 Group psychotherapy (other than of a multiple-family group) <1% 209 $2K
96112 <1% 28 $2K
29883 <1% 13 $2K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 13 $2K
0297T <1% 152 $2K
99443 <1% 43 $2K
20930 <1% 18 $2K
77290 <1% 40 $2K
96160 <1% 817 $2K
93016 <1% 113 $2K
61783 <1% 18 $2K
62328 <1% 34 $2K
99406 <1% 265 $2K
75635 <1% 44 $2K
73200 <1% 54 $2K
36223 <1% 15 $2K
43237 <1% 37 $2K
92225 <1% 69 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 128 $2K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 54 $2K
36620 <1% 70 $2K
11104 <1% 40 $2K
92235 <1% 50 $2K
77338 <1% 14 $2K
A9585 Injection, gadobutrol, 0.1 ml <1% 150 $2K
83020 <1% 152 $1K
00140 <1% 12 $1K
84165 <1% 224 $1K
99496 <1% 12 $1K
92136 <1% 84 $1K
95811 <1% 14 $1K
93356 <1% 146 $1K
99292 <1% 34 $1K
73000 <1% 209 $1K
76885 <1% 46 $1K
99459 <1% 93 $1K
99442 <1% 59 $1K
77001 <1% 189 $1K
64495 <1% 34 $1K
96111 <1% 28 $1K
75561 <1% 24 $1K
20550 <1% 36 $1K
93886 <1% 39 $1K
0295T <1% 50 $1K
92551 <1% 97 $1K
99219 <1% 16 $1K
92202 <1% 97 $1K
76519 <1% 36 $1K
72120 <1% 177 $1K
91010 <1% 13 $1K
99381 <1% 14 $958.68
73140 <1% 87 $955.53
95910 <1% 12 $934.19
54150 <1% 13 $915.24
78306 <1% 45 $903.36
92100 <1% 79 $864.05
11100 <1% 31 $846.50
95874 <1% 88 $820.61
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 90 $783.90
78816 <1% 14 $770.97
31652 <1% 14 $753.81
29075 <1% 27 $722.25
99140 <1% 534 $646.62
99498 <1% 20 $641.42
62370 <1% 49 $585.58
86334 <1% 43 $575.34
99252 <1% 15 $557.30
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 31 $549.12
31624 <1% 19 $545.61
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 47 $543.51
74328 <1% 34 $537.26
90670 <1% 124 $529.34
77092 <1% 117 $520.67
73701 <1% 16 $511.15
88341 <1% 17 $478.30
73650 <1% 61 $441.92
99188 <1% 29 $441.75
93243 <1% 132 $441.38
52000 <1% 13 $438.83
85097 <1% 19 $413.38
78227 <1% 14 $410.55
99174 <1% 27 $399.14
90681 <1% 45 $391.34
90472 Immunization administration, each additional vaccine (list separately) <1% 37 $376.70
93242 <1% 35 $353.92
74240 <1% 16 $349.83
99407 <1% 34 $347.71
77012 <1% 13 $332.27
64445 <1% 12 $329.56
90723 <1% 30 $315.19
99100 <1% 27 $300.00
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 56 $297.55
77077 <1% 32 $288.12
76886 <1% 12 $284.06
74420 <1% 30 $273.78
76857 <1% 27 $259.50
98926 <1% 15 $252.34
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision <1% 17 $232.99
88342 <1% 18 $223.76
72084 <1% 16 $200.48
17110 <1% 13 $190.39
20553 <1% 13 $182.92
J1030 Injection, methylprednisolone acetate, 40 mg <1% 28 $171.78
74019 <1% 15 $165.16
90461 <1% 31 $156.80
46600 <1% 18 $145.02
99308 Subsequent nursing facility care, per day, straightforward <1% 17 $126.57
92285 <1% 12 $125.01
95970 <1% 15 $123.00
88311 <1% 18 $116.14
51798 <1% 15 $115.73
72080 <1% 13 $103.36
90647 <1% 45 $101.07
73010 <1% 16 $81.94
70250 <1% 12 $73.66
99499 <1% 56 $58.50
88300 <1% 16 $57.80
83986 <1% 15 $22.09
90611 <1% 27 $0.07
90633 <1% 29 $0.01
3044F <1% 32 $0.01
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 0% 13 $0.00
99024 0% 32,565 $0.00
3008F 0% 14 $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 officialGRIDER, JAY (AUTHORIZED OFFICIAL)