Clinic
West Caldwell Health Council, INC.
West Caldwell Health Council, INC. was paid $1.76M by Medicaid between Jan 2018 and Dec 2024, across 7 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 88% of everything it billed.
33Billing provider infoWEST CALDWELL HEALTH COUNCIL, INC.
LENOIR, NC 28645
LENOIR, NC 28645
33aNPI1467513143assigned 12/13/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$1.76M
24GClaims40,614
24DCodes billed7
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in North Carolina
Rank by total paid#53 of 324
Median peer was paid$279K
This provider vs. median6.3×
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 | 2,123 | $204K | |
| 2019 | 2,044 | $223K | |
| 2020 | 1,936 | $267K | |
| 2021 | 4,975 | $368K | |
| 2022 | 9,436 | $261K | |
| 2023 | 9,593 | $185K | |
| 2024incomplete | 10,507 | $251K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 88% | 11,146 | 8,569 | $1.55M |
| 99199 | Unlisted special service, procedure or report | 9.0% | 26,183 | 15,769 | $158K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 2.6% | 1,917 | 1,643 | $45K |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 156 | 155 | $2K |
| 36415 | Collection of venous blood by venipuncture | <1% | 188 | 175 | $441.04 |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 14 | 13 | $288.60 |
| 99000 | 0% | 1,010 | 808 | $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 officialMCRARY, THOMAS (ASSISTANT ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| West Caldwell Health Council, INC. | Collettsville, NC | $744K |
| West Caldwell Health Council, INC. | Collettsville, NC | $544K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.