Ephraim Mcdowell Health Resource, INC.
Ephraim Mcdowell Health Resource, INC. was paid $517K by Medicaid between Jan 2018 and Dec 2024, across 14 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 47% of everything it billed.
LANCASTER, KY 40444
Next to other Family Medicine Physician providers in Kentucky
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 3,362 | $99K | |
| 2019 | 2,776 | $81K | |
| 2020 | 1,551 | $55K | |
| 2021 | 1,612 | $50K | |
| 2022 | 2,591 | $92K | |
| 2023 | 2,017 | $78K | |
| 2024incomplete | 1,652 | $62K |
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% | 7,663 | 6,363 | $242K |
| 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 | 45% | 4,900 | 4,206 | $231K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 2.1% | 592 | 302 | $11K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.7% | 110 | 99 | $9K |
| 36415 | Collection of venous blood by venipuncture | 1.2% | 1,485 | 1,337 | $6K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.1% | 173 | 161 | $6K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 203 | 99 | $4K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 242 | 232 | $3K |
| 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 | <1% | 42 | 42 | $3K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 22 | 13 | $844.79 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 30 | 30 | $815.42 |
| 97597 | <1% | 55 | 37 | $549.01 |
2 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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.