Physician
West Virginia Health Care Cooperative INC
West Virginia Health Care Cooperative INC was paid $3.09M by Medicaid between Aug 2019 and Dec 2024, across 39 billing codes. Its largest line is 99284, emergency room visit (serious) — 40% of everything it billed.
33Billing provider infoWEST VIRGINIA HEALTH CARE COOPERATIVE INC
SUMMERSVILLE, WV 26651
SUMMERSVILLE, WV 26651
33aNPI1417415324assigned 03/10/2019
33bProvider typeOrthopaedic Surgery Physician
28Total paid$3.09M
24GClaims55,278
24DCodes billed39
24AFirst – last monthAug 2019 – Dec 2024
Compared with peers
Next to other Orthopaedic Surgery Physician providers in West Virginia
Rank by total paid#4 of 19
Median peer was paid$210K
This provider vs. median15×
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 | |
|---|---|---|---|
| 2019 | 1,444 | $92K | |
| 2020 | 5,683 | $322K | |
| 2021 | 10,117 | $511K | |
| 2022 | 13,566 | $785K | |
| 2023 | 13,161 | $753K | |
| 2024incomplete | 11,307 | $627K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 40% | 14,215 | 12,037 | $1.24M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 15% | 8,844 | 7,991 | $453K |
| 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 | 12% | 5,890 | 5,108 | $365K |
| 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 | 6.8% | 2,253 | 2,023 | $211K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.2% | 3,542 | 3,120 | $162K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 3.7% | 922 | 794 | $115K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.9% | 1,466 | 1,365 | $89K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.9% | 1,120 | 1,064 | $60K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.8% | 1,806 | 1,543 | $54K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.6% | 1,194 | 464 | $51K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.6% | 638 | 432 | $49K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1.5% | 1,689 | 703 | $47K |
27 more codes
| 99238 | Hospital discharge day management, 30 minutes or less | 1.4% | 975 | $43K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 1.3% | 286 | $41K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 4,869 | $25K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 335 | $16K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 471 | $16K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 194 | $13K |
| 20610 | <1% | 292 | $11K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 76 | $8K |
| 82570 | <1% | 1,110 | $3K | |
| 99223 | Prolong inpt eval add15 m | <1% | 28 | $3K |
| 81001 | <1% | 1,080 | $3K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 182 | $3K |
| 51798 | <1% | 248 | $2K | |
| 99221 | <1% | 31 | $1K | |
| 93016 | <1% | 61 | $807.24 | |
| 90686 | <1% | 44 | $766.02 | |
| 99217 | <1% | 15 | $681.18 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 13 | $587.38 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 103 | $569.67 |
| 93018 | <1% | 61 | $535.73 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 306 | $497.41 |
| 99305 | <1% | 17 | $301.75 | |
| 11721 | <1% | 56 | $267.12 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 85 | $230.58 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 37 | $0.00 |
| 99024 | 0% | 701 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 23 | $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 officialBOWLING, KAREN (PRESIDENT /CEO)
| Provider | Location | Paid |
|---|---|---|
| West Virginia Health Care Cooperative INC | Summersville, WV | $19.20M |
| City of Jacksonville | Jacksonville, FL | $17.10M |
| West Virginia Health Care Cooperative INC | Summersville, WV | $1.61M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.