NP / PA
Lake Cumberland Gastroenterology and Internal Medicine Assoc. INC.
Lake Cumberland Gastroenterology and Internal Medicine Assoc. INC. was paid $123K by Medicaid between Jan 2018 and Nov 2019, across 29 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 47% of everything it billed.
33Billing provider infoLAKE CUMBERLAND GASTROENTEROLOGY AND INTERNAL MEDICINE ASSOC. INC.
SOMERSET, KY 42503
SOMERSET, KY 42503
33aNPI1407993074assigned 01/31/2007
33bProvider typeFamily Nurse Practitioner
28Total paid$123K
24GClaims21,175
24DCodes billed29
24AFirst – last monthJan 2018 – Nov 2019
Compared with peers
Next to other Family Nurse Practitioner providers in Kentucky
Rank by total paid#108 of 424
Median peer was paid$19K
This provider vs. median6.5×
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 | 12,615 | $82K | |
| 2019 | 8,560 | $41K |
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 | 47% | 2,252 | 2,037 | $58K |
| 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 | 19% | 259 | 257 | $23K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 18% | 212 | 205 | $23K |
| 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 | 8.4% | 272 | 260 | $10K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 1.7% | 599 | 480 | $2K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.6% | 741 | 702 | $2K |
| 80061 | Lipid panel | 1.5% | 198 | 193 | $2K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.4% | 436 | 405 | $2K |
| 83036 | Hemoglobin; glycosylated (A1C) | 1.1% | 291 | 269 | $1K |
| 3044F | <1% | 162 | 151 | $40.04 | |
| 81000 | <1% | 18 | 15 | $20.18 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 2,854 | 2,530 | $2.96 |
17 more codes
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 725 | $0.00 |
| 1036F | 0% | 1,685 | $0.00 | |
| 3017F | 0% | 1,646 | $0.00 | |
| 3014F | 0% | 164 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 1,073 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 675 | $0.00 |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 60 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 17 | $0.00 |
| 4040F | 0% | 434 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 488 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 1,846 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 1,856 | $0.00 |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 450 | $0.00 |
| 4004F | 0% | 972 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 731 | $0.00 |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 0% | 17 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 42 | $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 officialROBACK, BRENDA (OFFICE MANAGER)