Clinic
Grafton City Hospital INC
Grafton City Hospital INC was paid $4.42M by Medicaid between Jan 2018 and Sep 2024, across 40 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 93% of everything it billed.
33Billing provider infoGRAFTON CITY HOSPITAL INC
GRAFTON, WV 26354
GRAFTON, WV 26354
33aNPI1336200344assigned 12/13/2006
33bProvider typeRural Health Clinic/Center
28Total paid$4.42M
24GClaims86,976
24DCodes billed40
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in West Virginia
Rank by total paid#4 of 49
Median peer was paid$956K
This provider vs. median4.6×
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 | 11,106 | $628K | |
| 2019 | 6,865 | $337K | |
| 2020 | 12,898 | $761K | |
| 2021 | 17,045 | $695K | |
| 2022 | 14,452 | $805K | |
| 2023 | 16,200 | $787K | |
| 2024incomplete | 8,410 | $411K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 93% | 36,608 | 27,871 | $4.11M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.3% | 16,614 | 13,387 | $146K |
| 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 | 1.8% | 9,432 | 8,348 | $78K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | <1% | 198 | 178 | $23K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,606 | 1,487 | $20K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 499 | 432 | $13K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 765 | 681 | $11K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | <1% | 122 | 104 | $8K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 348 | 322 | $8K |
| 81002 | <1% | 365 | 327 | $5K | |
| 90686 | <1% | 43 | 39 | $2K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 59 | 48 | $1K |
28 more codes
| 90688 | <1% | 32 | $990.94 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 16 | $592.57 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 40 | $487.71 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 67 | $331.27 |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 30 | $167.98 |
| 1036F | 0% | 977 | $0.00 | |
| 3008F | 0% | 4,674 | $0.00 | |
| 3074F | 0% | 1,987 | $0.00 | |
| 3079F | 0% | 1,151 | $0.00 | |
| 1034F | 0% | 729 | $0.00 | |
| 1111F | 0% | 548 | $0.00 | |
| 99308 | Subsequent nursing facility care, per day, straightforward | 0% | 1,663 | $0.00 |
| 3075F | 0% | 347 | $0.00 | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 0% | 1,166 | $0.00 |
| 3080F | 0% | 303 | $0.00 | |
| 99406 | 0% | 45 | $0.00 | |
| 99441 | 0% | 201 | $0.00 | |
| 99443 | 0% | 21 | $0.00 | |
| 99307 | 0% | 310 | $0.00 | |
| 3078F | 0% | 1,537 | $0.00 | |
| 3077F | 0% | 649 | $0.00 | |
| 1159F | 0% | 2,456 | $0.00 | |
| 80305 | 0% | 336 | $0.00 | |
| 1160F | 0% | 558 | $0.00 | |
| 99442 | 0% | 385 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 36 | $0.00 |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 24 | $0.00 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 29 | $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 officialLILLEY, JEFFREY (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Grafton City Hospital INC | Grafton, WV | $6.45M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.