Physician
Claiborne Health & Wellness INC.
Claiborne Health & Wellness INC. was paid $503K by Medicaid between Dec 2020 and Dec 2024, across 52 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.
33Billing provider infoCLAIBORNE HEALTH & WELLNESS INC.
TAZEWELL, TN 37879
TAZEWELL, TN 37879
33aNPI1497350623assigned 12/04/2020
33bProvider typeChild & Adolescent Psychiatry Physician
28Total paid$503K
24GClaims45,524
24DCodes billed52
24AFirst – last monthDec 2020 – Dec 2024
Compared with peers
Next to other Child & Adolescent Psychiatry Physician providers in Tennessee
Rank by total paid#4 of 10
Median peer was paid$48K
This provider vs. median10×
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 | |
|---|---|---|---|
| 2020 | 53 | $397.28 | |
| 2021 | 16,582 | $134K | |
| 2022 | 15,143 | $157K | |
| 2023 | 9,075 | $121K | |
| 2024incomplete | 4,671 | $90K |
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 | 39% | 5,956 | 4,695 | $197K |
| 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% | 5,483 | 4,192 | $188K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 8.0% | 1,369 | 1,145 | $40K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 4.5% | 2,716 | 1,190 | $22K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.9% | 986 | 763 | $9K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 1.4% | 196 | 182 | $7K |
| 87428 | 1.3% | 150 | 109 | $7K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.3% | 374 | 179 | $6K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 1.2% | 32 | 14 | $6K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 458 | 395 | $4K |
| 96160 | <1% | 419 | 336 | $3K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,791 | 1,449 | $2K |
40 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 43 | $2K |
| 99406 | <1% | 257 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 16 | $875.37 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 12 | $797.92 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 93 | $776.37 |
| G3002 | Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) | <1% | 70 | $646.45 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 437 | $597.49 |
| 90688 | <1% | 64 | $528.65 | |
| 90686 | <1% | 84 | $497.20 | |
| 85018 | <1% | 269 | $454.00 | |
| 81003 | <1% | 271 | $338.98 | |
| 95115 | <1% | 70 | $310.52 | |
| 3078F | <1% | 4,021 | $308.94 | |
| 96127 | <1% | 104 | $281.68 | |
| 3077F | <1% | 1,310 | $281.18 | |
| 3079F | <1% | 1,587 | $261.18 | |
| 3074F | <1% | 3,745 | $241.31 | |
| 92552 | <1% | 12 | $187.06 | |
| 1125F | <1% | 3,730 | $180.00 | |
| 1126F | <1% | 2,811 | $170.00 | |
| 3075F | <1% | 871 | $150.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 15 | $134.37 |
| 3080F | <1% | 548 | $130.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 96 | $92.15 |
| 94760 | <1% | 240 | $78.20 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 145 | $62.99 |
| 36416 | <1% | 64 | $56.95 | |
| 90658 | <1% | 18 | $54.72 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 37 | $26.96 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 23 | $18.16 |
| 81001 | <1% | 17 | $14.03 | |
| 1033F | 0% | 2,880 | $0.00 | |
| 1032F | 0% | 1,222 | $0.00 | |
| 1159F | 0% | 17 | $0.00 | |
| 1160F | 0% | 18 | $0.00 | |
| 3049F | 0% | 276 | $0.00 | |
| 90694 | 0% | 18 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 24 | $0.00 |
| 3008F | 0% | 18 | $0.00 | |
| 1170F | 0% | 41 | $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 officialBAYS, PAMELA (CEO, OWNER)