Clinic
Cumberland Family Clinic, PLLC
Cumberland Family Clinic, PLLC was paid $948K by Medicaid between Jan 2018 and Dec 2024, across 17 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 69% of everything it billed.
33Billing provider infoCUMBERLAND FAMILY CLINIC, PLLC
PINE KNOT, KY 42635
PINE KNOT, KY 42635
33aNPI1366703159assigned 06/07/2012
33bProvider typeRural Health Clinic/Center
28Total paid$948K
24GClaims60,603
24DCodes billed17
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Kentucky
Rank by total paid#64 of 265
Median peer was paid$400K
This provider vs. median2.4×
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 | 12,732 | $205K | |
| 2019 | 12,384 | $185K | |
| 2020 | 7,316 | $116K | |
| 2021 | 7,223 | $106K | |
| 2022 | 7,896 | $124K | |
| 2023 | 7,182 | $117K | |
| 2024incomplete | 5,870 | $96K |
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 | 69% | 26,860 | 20,054 | $654K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7.9% | 3,566 | 3,051 | $74K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 7.3% | 6,161 | 4,908 | $69K |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 5.4% | 1,728 | 1,443 | $51K |
| 85027 | 4.4% | 8,144 | 6,940 | $41K | |
| 87430 | 2.2% | 1,801 | 1,693 | $21K | |
| 36415 | Collection of venous blood by venipuncture | 1.6% | 5,615 | 4,913 | $15K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.4% | 1,089 | 511 | $13K |
| 81001 | <1% | 2,292 | 1,965 | $3K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 302 | 275 | $2K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 2,785 | 2,460 | $2K |
| 84703 | <1% | 107 | 93 | $631.14 |
5 more codes
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 officialLAWSON, MONICA (PARTNER)