Clinic
Kentucky Mountain Health Alliance, INC.
Kentucky Mountain Health Alliance, INC. was paid $2.81M by Medicaid between Jan 2018 and Nov 2024, across 80 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 53% of everything it billed.
33Billing provider infoKENTUCKY MOUNTAIN HEALTH ALLIANCE, INC.
HAZARD, KY 41701
HAZARD, KY 41701
33aNPI1407043979assigned 09/28/2007
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$2.81M
24GClaims98,536
24DCodes billed80
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Kentucky
Rank by total paid#12 of 37
Median peer was paid$1.29M
This provider vs. median2.2×
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 | 5,547 | $113K | |
| 2019 | 5,072 | $111K | |
| 2020 | 6,250 | $238K | |
| 2021 | 6,423 | $169K | |
| 2022 | 5,301 | $158K | |
| 2023 | 32,163 | $979K | |
| 2024incomplete | 37,780 | $1.05M |
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 | 53% | 41,181 | 35,984 | $1.49M |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 4.2% | 8,446 | 7,937 | $118K |
| D0330 | Panoramic radiographic image | 4.1% | 2,458 | 2,363 | $114K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 4.0% | 2,381 | 984 | $114K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 3.5% | 4,327 | 4,110 | $99K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.3% | 2,720 | 2,622 | $92K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.8% | 1,477 | 1,385 | $78K |
| 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 | 2.3% | 1,342 | 1,150 | $64K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.2% | 4,594 | 2,590 | $63K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 2.1% | 900 | 630 | $60K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.6% | 604 | 215 | $45K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.4% | 736 | 602 | $39K |
68 more codes
| 99222 | Initial hospital care, per day, moderate complexity | 1.0% | 430 | $28K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 687 | $28K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 606 | $27K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 1,294 | $27K |
| G0467 | Community health center visit, returning patient | <1% | 3,152 | $25K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 404 | $22K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 347 | $21K |
| 98943 | <1% | 1,316 | $20K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 511 | $17K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 263 | $17K |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,643 | $15K |
| D5110 | <1% | 28 | $14K | |
| 80305 | <1% | 1,422 | $14K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,104 | $13K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 174 | $13K |
| 98942 | <1% | 440 | $11K | |
| D1110 | Prophylaxis - adult | <1% | 213 | $11K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 333 | $9K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 114 | $8K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 95 | $8K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 110 | $7K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 74 | $7K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 282 | $7K |
| D5120 | <1% | 14 | $7K | |
| 90723 | <1% | 151 | $7K | |
| 90710 | <1% | 55 | $6K | |
| 96127 | <1% | 2,137 | $5K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 177 | $5K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 49 | $4K |
| 90680 | <1% | 70 | $3K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 469 | $3K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 1,636 | $3K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 124 | $3K |
| D0140 | Limited oral evaluation - problem focused | <1% | 93 | $3K |
| 90461 | <1% | 39 | $2K | |
| 90647 | <1% | 169 | $2K | |
| 90674 | <1% | 92 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 32 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 45 | $2K |
| 99307 | <1% | 16 | $2K | |
| 92250 | <1% | 28 | $1K | |
| 90633 | <1% | 55 | $1K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 89 | $747.68 |
| 90688 | <1% | 63 | $703.15 | |
| 98968 | <1% | 45 | $671.00 | |
| 99442 | <1% | 35 | $603.98 | |
| 81025 | <1% | 111 | $566.13 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 15 | $535.30 |
| 90696 | <1% | 12 | $528.00 | |
| 90686 | <1% | 23 | $427.02 | |
| 90658 | <1% | 14 | $230.44 | |
| 99441 | <1% | 29 | $223.83 | |
| 99406 | <1% | 48 | $181.44 | |
| 81003 | <1% | 1,399 | $158.59 | |
| 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% | 258 | $135.70 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 20 | $105.80 |
| 97014 | <1% | 45 | $89.04 | |
| 97124 | <1% | 1,169 | $80.76 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 129 | $75.38 |
| 82962 | <1% | 26 | $71.61 | |
| 81002 | <1% | 67 | $69.18 | |
| 97010 | <1% | 52 | $65.45 | |
| 36416 | <1% | 15 | $26.22 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 14 | $24.20 |
| 90734 | <1% | 13 | $3.33 | |
| 99000 | 0% | 108 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 65 | $0.00 |
| D0383 | 0% | 13 | $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 officialVANCE, ELLEN (EXECUTIVE DIRECTOR)