Clinic
Clay City Pediatrics, PSC
Clay City Pediatrics, PSC was paid $3.29M by Medicaid between Jan 2018 and Dec 2024, across 82 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 59% of everything it billed.
33Billing provider infoCLAY CITY PEDIATRICS, PSC
CLAY CITY, KY 40312
CLAY CITY, KY 40312
33aNPI1396048872assigned 12/06/2010
33bProvider typePrimary Care Clinic/Center
28Total paid$3.29M
24GClaims150,831
24DCodes billed82
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Kentucky
Rank by total paid#2 of 44
Median peer was paid$145K
This provider vs. median23×
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 | 18,644 | $385K | |
| 2019 | 21,445 | $429K | |
| 2020 | 16,546 | $378K | |
| 2021 | 17,523 | $418K | |
| 2022 | 24,959 | $507K | |
| 2023 | 28,896 | $639K | |
| 2024incomplete | 22,818 | $533K |
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 | 59% | 64,478 | 50,778 | $1.95M |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 6.4% | 15,414 | 14,061 | $210K |
| 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 | 6.0% | 4,676 | 4,299 | $199K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 4.8% | 3,655 | 3,347 | $158K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.4% | 2,009 | 1,958 | $112K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.8% | 6,860 | 5,772 | $92K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.5% | 1,732 | 1,670 | $84K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.3% | 6,370 | 4,773 | $75K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.7% | 2,366 | 2,141 | $55K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.6% | 3,361 | 3,252 | $53K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.6% | 957 | 921 | $52K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.1% | 659 | 634 | $36K |
70 more codes
| 90461 | 1.0% | 3,367 | $34K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 474 | $30K |
| 95117 | <1% | 2,084 | $20K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 607 | $19K |
| 83655 | <1% | 1,838 | $18K | |
| 87807 | <1% | 1,568 | $18K | |
| 99441 | <1% | 608 | $16K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,254 | $16K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 560 | $7K |
| 95115 | <1% | 658 | $5K | |
| 85018 | <1% | 2,411 | $4K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 276 | $3K |
| 81025 | <1% | 292 | $2K | |
| 99383 | <1% | 27 | $2K | |
| 74018 | <1% | 169 | $1K | |
| 90670 | <1% | 968 | $1K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 38 | $1K |
| 90734 | <1% | 156 | $1K | |
| 90633 | <1% | 822 | $1K | |
| 90680 | <1% | 574 | $899.30 | |
| 92587 | <1% | 38 | $842.14 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,279 | $836.82 |
| 81003 | <1% | 1,982 | $737.85 | |
| 90649 | <1% | 171 | $709.32 | |
| 90686 | <1% | 357 | $580.03 | |
| 90688 | <1% | 39 | $564.56 | |
| 90619 | <1% | 125 | $555.48 | |
| 99050 | <1% | 34 | $457.00 | |
| 0002A | <1% | 21 | $400.00 | |
| 90648 | <1% | 809 | $393.75 | |
| 90723 | <1% | 309 | $340.64 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 97 | $335.63 |
| 86308 | <1% | 71 | $329.06 | |
| 90715 | <1% | 147 | $320.79 | |
| 99051 | <1% | 12 | $202.50 | |
| 93000 | <1% | 13 | $190.51 | |
| 90710 | <1% | 47 | $136.77 | |
| 73630 | <1% | 12 | $133.32 | |
| 90685 | <1% | 28 | $41.63 | |
| 90700 | <1% | 28 | $17.86 | |
| 90677 | <1% | 249 | $2.13 | |
| 3074F | <1% | 86 | $0.73 | |
| 1125F | <1% | 44 | $0.32 | |
| 90716 | <1% | 30 | $0.30 | |
| 1126F | <1% | 29 | $0.27 | |
| 3078F | <1% | 32 | $0.24 | |
| 90707 | <1% | 20 | $0.19 | |
| 90696 | <1% | 15 | $0.14 | |
| 1159F | <1% | 633 | $0.10 | |
| 1160F | <1% | 633 | $0.10 | |
| 3077F | <1% | 15 | $0.09 | |
| 1111F | <1% | 293 | $0.02 | |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 1,132 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 1,205 | $0.00 |
| 1036F | 0% | 1,348 | $0.00 | |
| G9906 | Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) | 0% | 1,126 | $0.00 |
| 3014F | 0% | 14 | $0.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 0% | 86 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 109 | $0.00 |
| 1034F | 0% | 66 | $0.00 | |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 76 | $0.00 |
| 3017F | 0% | 43 | $0.00 | |
| 91307 | 0% | 46 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 1,015 | $0.00 |
| 4004F | 0% | 2,129 | $0.00 | |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 1,754 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 138 | $0.00 |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 358 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 1,185 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 15 | $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 officialCAIN, STACEY (PRACTICE MANAGER)