Physician
Neurology & Headache Clinic PLLC
Neurology & Headache Clinic PLLC was paid $3.78M by Medicaid between Jan 2018 and Dec 2024, across 43 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 34% of everything it billed.
33Billing provider infoNEUROLOGY & HEADACHE CLINIC PLLC
CHARLESTON, WV 25304
CHARLESTON, WV 25304
33aNPI1336185164assigned 06/21/2006
33bProvider typeNeurology Physician
28Total paid$3.78M
24GClaims109,989
24DCodes billed43
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Neurology Physician providers in West Virginia
Rank by total paid#1 of 11
Median peer was paid$30K
This provider vs. median126×
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 | 24,056 | $805K | |
| 2019 | 21,888 | $517K | |
| 2020 | 25,397 | $498K | |
| 2021 | 11,387 | $501K | |
| 2022 | 10,293 | $514K | |
| 2023 | 9,535 | $541K | |
| 2024incomplete | 7,433 | $403K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 34% | 25,877 | 24,257 | $1.28M |
| 95886 | 12% | 4,227 | 4,081 | $449K | |
| 95816 | 9.9% | 2,585 | 2,441 | $374K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 9.1% | 4,331 | 4,099 | $343K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 7.4% | 5,526 | 1,189 | $279K |
| 95911 | 4.4% | 1,175 | 1,141 | $166K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.1% | 4,404 | 4,258 | $156K |
| 95913 | 3.4% | 679 | 654 | $129K | |
| 95910 | 2.1% | 739 | 714 | $80K | |
| G8783 | Normal blood pressure reading documented, follow-up not required | 2.1% | 6,747 | 6,435 | $79K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.6% | 801 | 771 | $59K |
| 1036F | 1.5% | 7,510 | 7,156 | $58K |
31 more codes
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 1.4% | 8,504 | $53K |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 1.4% | 8,274 | $52K |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 1.3% | 4,872 | $50K |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 1.3% | 5,046 | $48K |
| 4004F | 1.1% | 3,498 | $43K | |
| G9534 | Advanced brain imaging (cta, ct, mra or mri) was not ordered | <1% | 1,146 | $25K |
| G9634 | Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved | <1% | 1,025 | $16K |
| 99483 | Prolong outpt/office vis | <1% | 583 | $15K |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | <1% | 904 | $11K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 35 | $3K |
| 4340F | <1% | 1,318 | $2K | |
| 99442 | <1% | 174 | $2K | |
| 1123F | <1% | 1,888 | $2K | |
| 99219 | <1% | 26 | $2K | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | <1% | 265 | $1K |
| 95909 | <1% | 13 | $933.78 | |
| 99225 | <1% | 31 | $929.29 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 17 | $472.80 |
| 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% | 216 | $356.60 |
| 3288F | <1% | 1,143 | $225.16 | |
| 1124F | <1% | 655 | $74.51 | |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 788 | $0.00 |
| M1016 | Female patients unable to bear children | 0% | 1,330 | $0.00 |
| 0518F | 0% | 612 | $0.00 | |
| 4322F | 0% | 867 | $0.00 | |
| G9916 | Functional status performed once in the last 12 months | 0% | 870 | $0.00 |
| 3720F | 0% | 189 | $0.00 | |
| G9621 | Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling | 0% | 40 | $0.00 |
| 4400F | 0% | 81 | $0.00 | |
| G9922 | Safety concerns screen provided and if positive then documented mitigation recommendations | 0% | 866 | $0.00 |
| G2121 | Depression, anxiety, apathy, and psychosis assessed | 0% | 112 | $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 officialDAVE, DARSHANKUMAR (OWNER)