Physician
Upper Cumberland Rural Health Clinic PLLC
Upper Cumberland Rural Health Clinic PLLC was paid $3.60M by Medicaid between Jan 2018 and Dec 2024, across 72 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 62% of everything it billed.
33Billing provider infoUPPER CUMBERLAND RURAL HEALTH CLINIC PLLC
COOKEVILLE, TN 38501
COOKEVILLE, TN 38501
33aNPI1346388246assigned 02/02/2007
33bProvider typeFamily Medicine Physician
28Total paid$3.60M
24GClaims207,940
24DCodes billed72
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Tennessee
Rank by total paid#16 of 754
Median peer was paid$34K
This provider vs. median107×
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 | 10,268 | $170K | |
| 2019 | 26,184 | $451K | |
| 2020 | 18,991 | $376K | |
| 2021 | 39,217 | $550K | |
| 2022 | 44,570 | $619K | |
| 2023 | 37,512 | $753K | |
| 2024incomplete | 31,198 | $682K |
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 | 62% | 81,953 | 56,032 | $2.22M |
| 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 | 23% | 24,523 | 17,589 | $826K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.7% | 1,836 | 1,510 | $98K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 2.2% | 3,734 | 879 | $78K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.4% | 850 | 661 | $50K |
| 87428 | 1.4% | 867 | 811 | $50K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.2% | 5,151 | 3,128 | $43K |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | 1.0% | 7,872 | 5,777 | $36K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 411 | 363 | $29K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 1,669 | 1,214 | $23K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,042 | 872 | $22K |
| 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 | <1% | 326 | 246 | $21K |
60 more codes
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 701 | $17K |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | <1% | 750 | $8K |
| 90674 | <1% | 615 | $8K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 181 | $8K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 980 | $7K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 158 | $7K |
| 96127 | <1% | 1,955 | $6K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 332 | $5K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 919 | $4K |
| 99490 | Ccm add 20min | <1% | 1,412 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 354 | $3K |
| 90756 | <1% | 185 | $3K | |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | <1% | 263 | $2K |
| 3008F | <1% | 17,342 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 28 | $2K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | <1% | 87 | $2K |
| 99442 | <1% | 99 | $2K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 59 | $2K |
| 90686 | <1% | 140 | $2K | |
| 99441 | <1% | 128 | $1K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 109 | $1K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 16 | $1K |
| 90715 | <1% | 66 | $1K | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 312 | $1K |
| 0001A | <1% | 42 | $920.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 95 | $821.35 |
| 93000 | <1% | 99 | $761.52 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 587 | $761.07 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 166 | $759.07 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 263 | $697.73 |
| G0008 | Administration of influenza virus vaccine | <1% | 294 | $672.91 |
| 99443 | <1% | 34 | $650.28 | |
| 0011A | <1% | 27 | $637.02 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,127 | $595.18 |
| 92551 | <1% | 80 | $584.14 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 30 | $521.73 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 38 | $509.20 |
| 98925 | <1% | 25 | $485.86 | |
| 0002A | <1% | 16 | $480.00 | |
| 80305 | <1% | 165 | $461.06 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 407 | $459.32 |
| 36415 | Collection of venous blood by venipuncture | <1% | 404 | $333.75 |
| 99173 | <1% | 50 | $292.32 | |
| 99050 | <1% | 43 | $252.15 | |
| 81003 | <1% | 256 | $196.02 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,562 | $185.59 |
| 90653 | <1% | 55 | $159.96 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 16 | $37.80 |
| 3078F | <1% | 5,485 | $20.01 | |
| 3074F | <1% | 5,886 | $20.00 | |
| 1159F | <1% | 6,813 | $0.02 | |
| 1160F | <1% | 6,812 | $0.01 | |
| 1126F | <1% | 3,079 | $0.01 | |
| 3077F | 0% | 2,750 | $0.00 | |
| 4004F | 0% | 182 | $0.00 | |
| 1125F | 0% | 5,493 | $0.00 | |
| 1036F | 0% | 2,279 | $0.00 | |
| 3075F | 0% | 1,373 | $0.00 | |
| 3079F | 0% | 3,558 | $0.00 | |
| 3080F | 0% | 924 | $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 officialJAIN, PUSHPENDRA (CEO)
| Provider | Location | Paid |
|---|---|---|
| Cookeville Medical Center PC | Cookeville, TN | $1.21M |
| Emergency Services Corporation of America | Cookeville, TN | $248K |
| Upper Cumberland Rural Health Clinic PLLC | Gainesboro, TN | $110.92 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.