Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Behavioral

Norton Childrens Medical Group, LLC

Norton Childrens Medical Group, LLC was paid $107.36M by Medicaid between Mar 2020 and Dec 2024, across 313 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 17% of everything it billed.

33Billing provider infoNORTON CHILDRENS MEDICAL GROUP, LLC
LOUISVILLE, KY 40241
33aNPI1326695255assigned 08/26/2019
33bProvider typeClinical Social Worker
28Total paid$107.36M
24GClaims3,157,297
24DCodes billed313
24AFirst – last monthMar 2020 – Dec 2024
Compared with peers

Next to other Clinical Social Worker providers in Kentucky

Rank by total paid#1 of 275
Median peer was paid$57K
This provider vs. median1,870×

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 GAST, SHELLEY controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$1.0M$2.0M$3.0M2018201920202021202220232024
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
2020368,667$10.62M
2021613,806$21.25M
2022727,089$25.36M
2023744,204$25.93M
2024incomplete703,531$24.20M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 17% 321,096 300,425 $18.58M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 13% 352,567 327,431 $13.43M
90460 Immunization administration through 18 years of age via any route, first or only component 7.9% 254,010 246,502 $8.51M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 7.2% 104,578 101,701 $7.68M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 6.3% 105,188 98,877 $6.74M
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 4.8% 40,445 38,706 $5.19M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 4.6% 121,293 116,836 $4.90M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 3.6% 59,377 57,208 $3.90M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 3.0% 44,930 43,614 $3.21M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 2.9% 40,036 36,926 $3.14M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 1.8% 19,602 18,333 $1.93M
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 1.6% 18,903 17,705 $1.72M
301 more codes
99204 Doctor's office visit, new patient (more involved) 1.5% 19,011 $1.63M
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1.3% 45,061 $1.41M
99244 Office or other outpatient consultation, moderate to high complexity 1.2% 11,357 $1.25M
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 13,636 $1.07M
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 35,756 $1.02M
99238 Hospital discharge day management, 30 minutes or less <1% 24,312 $1.02M
99173 <1% 18,142 $902K
99232 Hospital visit by a doctor, follow-up day <1% 24,748 $845K
99460 <1% 20,976 $805K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 8,168 $791K
99480 Subsequent intensive care, per day, low birth weight infant <1% 9,081 $788K
93320 <1% 19,439 $687K
99479 Subsequent intensive care, per day, very low birth weight infant <1% 7,618 $636K
95720 <1% 4,710 $595K
93325 <1% 27,589 $556K
70551 Magnetic resonance imaging, brain; without contrast material <1% 9,329 $554K
93000 <1% 25,447 $497K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 34,043 $481K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 10,537 $463K
99243 <1% 6,327 $462K
99203 Doctor's office visit, new patient (routine) <1% 7,319 $427K
76770 <1% 12,351 $402K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 53,958 $398K
90670 <1% 51,392 $353K
87631 <1% 2,690 $352K
71045 Radiologic examination, chest; single view <1% 54,019 $346K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) <1% 7,048 $340K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 14,265 $288K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 2,733 $282K
70450 Computed tomography, head or brain; without contrast material <1% 7,330 $277K
90472 Immunization administration, each additional vaccine (list separately) <1% 14,265 $261K
99462 <1% 12,774 $251K
99239 Hospital discharge day management, more than 30 minutes <1% 3,478 $231K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 1,884 $225K
83655 <1% 17,903 $216K
90677 <1% 17,281 $215K
71046 Radiologic examination, chest; 2 views <1% 24,937 $214K
74018 <1% 30,918 $210K
99205 Prolong outpt/office vis <1% 2,308 $208K
99222 Initial hospital care, per day, moderate complexity <1% 2,700 $206K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 2,931 $199K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 23,013 $193K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 2,544 $181K
99223 Prolong inpt eval add15 m <1% 1,657 $175K
36416 <1% 78,394 $167K
92551 <1% 15,580 $162K
74019 <1% 15,885 $142K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger <1% 639 $142K
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years <1% 852 $137K
54150 <1% 2,165 $129K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 1,162 $125K
99245 <1% 831 $113K
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 2,061 $112K
0001A <1% 3,330 $109K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 2,164 $109K
96127 <1% 29,768 $106K
90839 <1% 1,307 $103K
80061 Lipid panel <1% 7,814 $102K
0071A <1% 2,919 $97K
0072A <1% 2,356 $90K
99174 <1% 5,072 $89K
0002A <1% 2,531 $88K
99188 <1% 6,795 $87K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 3,245 $80K
83036 Hemoglobin; glycosylated (A1C) <1% 9,408 $80K
64643 <1% 982 $77K
90680 <1% 35,176 $75K
92587 <1% 2,069 $74K
72141 <1% 1,078 $73K
14040 <1% 448 $70K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 620 $69K
94060 <1% 2,312 $69K
77073 <1% 2,398 $66K
95812 <1% 1,484 $62K
54161 <1% 755 $60K
72082 <1% 1,552 $60K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 2,615 $58K
99254 <1% 662 $56K
54360 <1% 163 $56K
51728 <1% 739 $54K
94010 <1% 3,082 $54K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 558 $51K
90474 <1% 4,257 $50K
76506 <1% 2,067 $50K
99417 Prolong home eval add 15m <1% 919 $48K
72146 <1% 721 $48K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 634 $47K
90791 Psychiatric diagnostic evaluation <1% 607 $45K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 241 $44K
93304 <1% 1,109 $43K
95782 <1% 494 $43K
81025 <1% 6,292 $43K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 663 $43K
96161 <1% 14,978 $42K
72170 <1% 2,501 $42K
54300 <1% 111 $41K
64642 <1% 576 $40K
51797 <1% 746 $39K
36415 Collection of venous blood by venipuncture <1% 16,123 $38K
90480 <1% 2,486 $36K
90461 <1% 128,297 $33K
A4590 Special casting material (e.g., fiberglass) <1% 3,124 $33K
99349 <1% 340 $33K
90792 Psychiatric diagnostic evaluation with medical services <1% 339 $32K
93227 <1% 1,065 $32K
55175 <1% 280 $31K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 2,153 $29K
95251 <1% 1,869 $29K
96160 <1% 10,219 $27K
51784 <1% 742 $26K
99383 <1% 394 $26K
95816 <1% 496 $26K
90832 Psychotherapy session, about 30 minutes <1% 674 $25K
82947 <1% 6,529 $25K
99471 <1% 45 $25K
90651 <1% 4,969 $24K
92567 <1% 1,881 $24K
36512 <1% 490 $23K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies <1% 28 $22K
95718 <1% 285 $22K
99335 <1% 454 $22K
82044 <1% 4,091 $21K
99384 <1% 306 $21K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 933 $20K
90698 <1% 57,758 $20K
93321 <1% 1,935 $20K
90686 <1% 86,416 $19K
82570 <1% 4,086 $19K
74230 <1% 863 $18K
74240 <1% 573 $17K
54304 <1% 33 $15K
25600 <1% 80 $15K
73630 <1% 1,235 $15K
90834 Psychotherapy session, about 45 minutes <1% 442 $15K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 1,011 $14K
87807 <1% 1,099 $13K
51600 <1% 698 $13K
92579 <1% 782 $13K
95874 <1% 1,012 $13K
93976 <1% 318 $12K
85018 <1% 4,766 $11K
81003 <1% 9,491 $11K
72081 <1% 459 $11K
99217 <1% 252 $11K
99336 <1% 126 $10K
74455 <1% 613 $9K
99235 <1% 77 $9K
63200 <1% 13 $9K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 53 $8K
0004A <1% 226 $8K
99381 <1% 114 $8K
0081A <1% 288 $8K
73100 <1% 404 $7K
90744 <1% 19,416 $7K
76885 <1% 227 $7K
90847 Family psychotherapy with the patient present, 50 minutes <1% 148 $7K
76800 <1% 141 $7K
90840 <1% 149 $6K
73070 <1% 516 $6K
93296 <1% 361 $6K
92582 <1% 134 $6K
76825 <1% 179 $6K
99219 <1% 80 $6K
69990 <1% 43 $6K
73090 <1% 766 $6K
90707 <1% 2,734 $6K
64644 <1% 81 $6K
76827 <1% 180 $6K
0054A <1% 162 $5K
90633 <1% 25,502 $5K
95819 <1% 94 $5K
0151A <1% 142 $5K
99255 <1% 42 $5K
96112 <1% 71 $5K
77072 <1% 713 $5K
99242 <1% 91 $5K
70544 <1% 113 $5K
73564 <1% 167 $5K
99220 <1% 45 $4K
0052A <1% 130 $4K
90837 Psychotherapy session, about an hour <1% 88 $4K
96380 <1% 251 $4K
99464 <1% 100 $4K
73590 <1% 539 $4K
73610 <1% 503 $4K
73560 <1% 262 $4K
99177 <1% 1,160 $4K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder <1% 134 $4K
0171A <1% 90 $4K
92583 <1% 152 $3K
31575 <1% 65 $3K
92526 <1% 111 $3K
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% 3,780 $3K
51741 <1% 96 $3K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 96 $3K
99310 Prolong nursin fac eval 15m <1% 40 $3K
0074A <1% 88 $3K
92555 <1% 299 $3K
99490 Ccm add 20min <1% 77 $2K
96156 <1% 73 $2K
99236 Prolong inpt eval add15 m <1% 13 $2K
76870 <1% 79 $2K
93294 <1% 110 $2K
70486 <1% 44 $2K
0051A <1% 56 $2K
49446 <1% 16 $2K
76536 <1% 79 $2K
73521 <1% 167 $2K
0121A <1% 53 $2K
69210 <1% 85 $2K
99253 <1% 27 $2K
82247 <1% 365 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 114 $2K
90656 <1% 13,039 $2K
99418 Prolong nursin fac eval 15m <1% 30 $2K
0082A <1% 62 $2K
75573 <1% 18 $2K
17110 <1% 82 $2K
0112A <1% 82 $2K
92552 <1% 141 $1K
90697 <1% 6,249 $1K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 27 $1K
99439 <1% 26 $1K
0124A <1% 36 $1K
90734 <1% 1,011 $1K
99218 <1% 27 $1K
90716 <1% 4,805 $1K
82465 <1% 282 $1K
92652 <1% 14 $1K
0154A <1% 35 $1K
99348 <1% 13 $1K
73130 <1% 137 $1K
0111A <1% 59 $1K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 20 $992.35
99382 <1% 14 $966.49
99221 <1% 21 $952.08
29450 <1% 22 $908.64
95813 <1% 13 $851.19
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 15 $804.32
58300 <1% 14 $772.78
90696 <1% 1,889 $768.99
73110 <1% 76 $740.17
90710 <1% 2,496 $710.84
92504 <1% 81 $706.84
99304 <1% 15 $691.60
77076 <1% 29 $657.46
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 672 $642.48
76000 <1% 51 $631.10
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 44 $600.58
99308 Subsequent nursing facility care, per day, straightforward <1% 14 $590.66
76775 <1% 14 $583.84
0083A <1% 18 $573.20
99252 <1% 16 $568.99
93784 <1% 20 $524.21
74430 <1% 40 $507.78
96113 <1% 25 $459.11
93225 <1% 12 $414.55
2014F <1% 29,318 $386.85
76857 <1% 14 $358.85
73620 <1% 14 $321.06
85014 <1% 133 $308.13
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 20 $295.62
95117 <1% 23 $294.18
3008F <1% 118,281 $290.60
86308 <1% 59 $279.29
90700 <1% 214 $224.38
83718 <1% 29 $203.58
70360 <1% 25 $189.07
85027 <1% 25 $161.19
51798 <1% 14 $134.49
77080 <1% 14 $92.37
90648 <1% 167 $90.84
94664 <1% 13 $89.14
73140 <1% 16 $87.47
90688 <1% 64 $71.36
97802 <1% 411 $23.15
97803 <1% 940 $12.23
90785 <1% 66 $7.82
91300 <1% 138 $0.02
99024 0% 26,039 $0.00
91307 0% 170 $0.00
91318 0% 366 $0.00
91317 0% 109 $0.00
90619 0% 1,901 $0.00
91319 0% 302 $0.00
90381 0% 134 $0.00
91305 0% 380 $0.00
90620 0% 56 $0.00
91315 0% 142 $0.00
90723 0% 12 $0.00
91312 0% 67 $0.00
90713 0% 1,570 $0.00
90715 0% 1,471 $0.00
91320 0% 179 $0.00
91308 0% 72 $0.00
99401 0% 50 $0.00
91321 0% 52 $0.00
90380 0% 12 $0.00
90714 0% 12 $0.00
90687 0% 14 $0.00
90672 0% 12 $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 officialGAST, SHELLEY (SYST VP OF MNGD CARE & PAYOR STRAT)
Same official

Other billing entities under GAST, SHELLEY

Full network →
ProviderLocationPaid
Norton Hospitals INCLouisville, KY$419.58M
Norton Hospitals, INCLouisville, KY$299.00M
Community Medical Associates, INC.Louisville, KY$135.33M
Community Medical Associates, INC.Louisville, KY$48.97M
Norton Clark Hospital, LLCJeffersonville, IN$19.62M
Norton - Kings Daughters Health INCMadison, IN$11.81M
Norton Scott Hospital, LLCScottsburg, IN$9.17M
Norton Clark Physician Practices, LLCClarksville, IN$7.07M
Norton Hospitals INCLouisville, KY$3.38M
Community Medical Associates, INC.Louisville, KY$1.21M
Norton Children's Medical Group, LLCLouisville, KY$1.15M
Community Medical Associates, INC.Louisville, KY$957K
Community Medical Associates, INC.Louisville, KY$808K
Norton Scott Hospital, LLCScottsburg, IN$560K
Norton Hospitals, INCLouisville, KY$438K
Community Medical Associates, INC.Louisville, KY$357K
Norton Clark Physician Practices, LLCSellersburg, IN$273K
Norton Children's Medical Group, LLCLouisville, KY$260K
Norton Children's Medical Group, LLCLouisville, KY$238K
Norton Children's Medical Group, LLCLouisville, KY$189K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.