Behavioral
ST. Claire Medical Center
ST. Claire Medical Center was paid $2.40M by Medicaid between Jan 2018 and Nov 2024, across 32 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 19% of everything it billed.
33Billing provider infoST. CLAIRE MEDICAL CENTER
MOREHEAD, KY 40351
MOREHEAD, KY 40351
33aNPI1407999295assigned 02/14/2007
33bProvider typePsychologist
28Total paid$2.40M
24GClaims60,017
24DCodes billed32
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Psychologist providers in Kentucky
Rank by total paid#13 of 40
Median peer was paid$395K
This provider vs. median6.1×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official LLOYD, DONALD controls 20+ related entities in our dataset. Read more
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 | 8,022 | $275K | |
| 2019 | 8,933 | $318K | |
| 2020 | 10,536 | $415K | |
| 2021 | 9,657 | $402K | |
| 2022 | 7,133 | $303K | |
| 2023 | 7,749 | $327K | |
| 2024incomplete | 7,987 | $358K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 19% | 10,665 | 9,055 | $457K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 17% | 11,691 | 7,525 | $417K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 9.5% | 8,402 | 3,026 | $228K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.6% | 6,727 | 4,370 | $207K |
| 99223 | Prolong inpt eval add15 m | 8.1% | 2,245 | 1,935 | $195K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 7.6% | 4,671 | 2,020 | $183K |
| 99239 | Hospital discharge day management, more than 30 minutes | 6.9% | 3,340 | 2,815 | $166K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 5.0% | 1,978 | 1,389 | $119K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 4.4% | 1,729 | 1,441 | $105K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 3.3% | 2,128 | 1,608 | $80K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 3.0% | 964 | 919 | $72K |
| 99442 | 2.0% | 1,430 | 1,152 | $49K |
20 more codes
| 99215 | Doctor's office visit, returning patient (complex) | 1.1% | 450 | $27K |
| 99205 | Prolong outpt/office vis | <1% | 282 | $24K |
| 99443 | <1% | 472 | $18K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 783 | $11K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 248 | $10K |
| 98968 | <1% | 474 | $10K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 374 | $9K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 202 | $3K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 82 | $2K |
| 98967 | <1% | 225 | $2K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 36 | $2K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 17 | $810.71 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 108 | $759.42 |
| 90785 | <1% | 61 | $286.02 | |
| 99306 | Prolong nursin fac eval 15m | <1% | 14 | $272.52 |
| 99305 | <1% | 15 | $132.63 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 16 | $30.12 |
| 1126F | <1% | 111 | $0.32 | |
| 1159F | 0% | 39 | $0.00 | |
| 1160F | 0% | 38 | $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 officialLLOYD, DONALD (CEO/PRESIDENT)
Parent organizationST. CLAIRE MEDICAL CENTER DBA ST. CLAIRE COUNSELING
| Provider | Location | Paid |
|---|---|---|
| ST Claire Medical Center INC | Morehead, KY | $71.27M |
| ST Claire Medical Center INC. | Morehead, KY | $4.05M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.32M |
| ST Claire Medical Center, INC., | Morehead, KY | $3.31M |
| ST Claire Medical Center, INC | Morehead, KY | $3.29M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.11M |
| ST Claire Medical Center, INC., | Morehead, KY | $2.42M |
| ST. Claire Medical Center, INC. | Morehead, KY | $2.09M |
| ST Claire Regional Radiology Physicians Services | Morehead, KY | $1.83M |
| ST Claire Medical Center, INC., | Morehead, KY | $1.46M |
| ST. Claire Medical Center,inc | Olive Hill, KY | $1.13M |
| ST. Claire Medical Center, INC | Owingsville, KY | $964K |
| ST. Claire Medical Center,inc | Sandy Hook, KY | $948K |
| ST. Claire Medical Center, INC | Frenchburg, KY | $877K |
| ST Claire Medical Center, INC | Morehead, KY | $760K |
| ST. Claire Medical Center, INC | Morehead, KY | $672K |
| ST. Claire Medical Center, INC. | Morehead, KY | $411K |
| ST. Claire Medical Center INC. | Morehead, KY | $371K |
| ST Claire Medical Center INC. | Morehead, KY | $115K |
| ST. Claire Medical Center, INC. | Morehead, KY | $20K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.