Clinic
ST. Claire Medical Center,inc
ST. Claire Medical Center,inc was paid $948K by Medicaid between Jan 2018 and Nov 2024, across 38 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 49% of everything it billed.
33Billing provider infoST. CLAIRE MEDICAL CENTER,INC
SANDY HOOK, KY 41171
SANDY HOOK, KY 41171
33aNPI1447212493assigned 04/05/2006
33bProvider typePrimary Care Clinic/Center
28Total paid$948K
24GClaims46,224
24DCodes billed38
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Kentucky
Rank by total paid#12 of 44
Median peer was paid$145K
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.
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 | 5,414 | $140K | |
| 2019 | 6,099 | $146K | |
| 2020 | 5,301 | $149K | |
| 2021 | 4,608 | $114K | |
| 2022 | 6,068 | $131K | |
| 2023 | 9,361 | $165K | |
| 2024incomplete | 9,373 | $103K |
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 | 49% | 15,359 | 12,892 | $469K |
| 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 | 37% | 8,444 | 7,493 | $353K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.1% | 1,824 | 916 | $20K |
| 36415 | Collection of venous blood by venipuncture | 1.6% | 5,308 | 4,746 | $15K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 649 | 590 | $14K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.3% | 490 | 240 | $12K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.2% | 764 | 737 | $12K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 1.2% | 357 | 343 | $11K |
| 99442 | <1% | 191 | 163 | $8K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 715 | 680 | $7K |
| 98968 | <1% | 241 | 162 | $7K | |
| 99441 | <1% | 170 | 142 | $6K |
26 more codes
| 90686 | <1% | 334 | $4K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 129 | $2K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 40 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 29 | $2K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 55 | $981.46 |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 37 | $806.84 |
| 98967 | <1% | 47 | $735.08 | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 18 | $627.54 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 15 | $520.89 |
| 87428 | <1% | 16 | $434.75 | |
| 87807 | <1% | 29 | $318.43 | |
| 90656 | <1% | 12 | $208.95 | |
| 81002 | <1% | 360 | $129.43 | |
| 90633 | <1% | 121 | $55.22 | |
| 3074F | <1% | 2,820 | $15.18 | |
| 3078F | <1% | 1,813 | $14.63 | |
| 1126F | <1% | 1,630 | $8.51 | |
| 3079F | <1% | 1,289 | $7.13 | |
| 1125F | <1% | 1,030 | $5.65 | |
| 3077F | <1% | 358 | $1.85 | |
| 3044F | <1% | 47 | $0.21 | |
| 3080F | <1% | 28 | $0.14 | |
| 1159F | <1% | 705 | $0.14 | |
| 1160F | <1% | 711 | $0.14 | |
| G0008 | Administration of influenza virus vaccine | 0% | 12 | $0.00 |
| 91301 | 0% | 27 | $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 (PRESIDENT/CEO)
| 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 | Morehead, KY | $2.40M |
| 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 | 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.