Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Behavioral

Pikeville Medical Center INC.

Pikeville Medical Center INC. was paid $34.42M by Medicaid between Jan 2018 and Dec 2024, across 256 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 22% of everything it billed.

33Billing provider infoPIKEVILLE MEDICAL CENTER INC.
PIKEVILLE, KY 41501
33aNPI1528195864assigned 02/27/2007
33bProvider typePsychologist
28Total paid$34.42M
24GClaims1,022,976
24DCodes billed256
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Psychologist providers in Kentucky

Rank by total paid#3 of 40
Median peer was paid$395K
This provider vs. median87×

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

$0$200K$400K$600K2018201920202021202220232024
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
YearClaimsPaid
2018153,326$5.38M
2019141,318$5.01M
2020133,951$4.61M
2021137,701$4.60M
2022140,289$4.58M
2023165,693$5.56M
2024incomplete150,698$4.69M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 22% 278,089 242,380 $7.63M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 12% 75,191 70,285 $4.26M
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 8.2% 70,249 62,658 $2.82M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 6.3% 25,618 10,746 $2.17M
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 5.1% 40,492 36,100 $1.76M
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 4.6% 71,794 27,668 $1.59M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 4.1% 39,338 36,673 $1.41M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 3.8% 16,562 15,231 $1.31M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2.6% 55,396 46,941 $910K
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 2.4% 11,310 10,181 $815K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.9% 18,412 16,598 $651K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1.8% 97,121 81,731 $612K
244 more codes
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1.5% 5,492 $519K
97153 Applied behavior analysis (autism therapy), per 15 minutes 1.3% 2,769 $439K
99239 Hospital discharge day management, more than 30 minutes 1.2% 10,143 $406K
99222 Initial hospital care, per day, moderate complexity 1.2% 7,999 $401K
59410 1.1% 523 $384K
20610 1.1% 10,254 $371K
99233 Hospital visit by a doctor, follow-up day (complex) 1.0% 10,830 $352K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 10,022 $334K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 5,934 $319K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 8,734 $236K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 3,707 $220K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 8,690 $182K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 900 $175K
99238 Hospital discharge day management, 30 minutes or less <1% 4,283 $149K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 893 $138K
99243 <1% 1,602 $126K
00170 Anesthesia for intraoral procedures, including biopsy <1% 1,756 $122K
99480 Subsequent intensive care, per day, low birth weight infant <1% 1,298 $115K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 4,755 $113K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) <1% 178 $112K
29826 <1% 474 $92K
99223 Prolong inpt eval add15 m <1% 1,457 $91K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 1,361 $87K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 2,330 $86K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 4,952 $84K
93454 <1% 761 $84K
59025 Fetal non-stress test <1% 3,629 $83K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 2,161 $81K
99221 <1% 2,991 $81K
76830 Ultrasound, transvaginal <1% 2,788 $72K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 2,186 $71K
99460 <1% 1,628 $70K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 433 $67K
97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes <1% 568 $65K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 2,964 $63K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 4,839 $63K
90935 Hemodialysis procedure with single evaluation by a physician <1% 1,719 $61K
71045 Radiologic examination, chest; single view <1% 11,077 $57K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 877 $54K
99219 <1% 986 $54K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 926 $53K
99217 <1% 1,551 $52K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 710 $49K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 627 $48K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 352 $46K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis <1% 487 $44K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 1,794 $40K
00731 <1% 1,118 $40K
29824 <1% 462 $37K
93018 <1% 2,845 $37K
93298 <1% 2,222 $34K
90791 Psychiatric diagnostic evaluation <1% 628 $33K
92557 <1% 1,796 $32K
93016 <1% 2,541 $31K
27447 <1% 53 $29K
96112 <1% 328 $27K
77067 Screening mammography, bilateral, including computer-aided detection <1% 977 $24K
70450 Computed tomography, head or brain; without contrast material <1% 1,015 $24K
96113 <1% 326 $23K
95806 <1% 241 $23K
92588 <1% 679 $23K
93294 <1% 1,683 $22K
29880 <1% 95 $21K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 320 $21K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 448 $21K
93458 <1% 164 $21K
59515 <1% 37 $21K
92567 <1% 2,306 $21K
99215 Doctor's office visit, returning patient (complex) <1% 421 $20K
31575 <1% 484 $20K
29823 <1% 187 $19K
77427 <1% 270 $18K
88307 <1% 392 $18K
29879 <1% 67 $17K
96130 <1% 258 $16K
76819 Fetal biophysical profile; without non-stress testing <1% 749 $16K
95909 <1% 342 $16K
36569 <1% 318 $16K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 80 $16K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 467 $16K
11721 <1% 1,072 $15K
71046 Radiologic examination, chest; 2 views <1% 2,267 $15K
99152 <1% 1,377 $14K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 263 $14K
90846 Family psychotherapy without the patient present, 50 minutes <1% 247 $14K
97597 <1% 960 $14K
93280 <1% 741 $13K
99386 <1% 144 $13K
G6002 Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy <1% 1,378 $13K
49083 <1% 216 $13K
72141 <1% 249 $13K
96131 <1% 256 $12K
59514 <1% 25 $12K
93970 <1% 653 $12K
93922 <1% 1,314 $12K
78815 Positron emission tomography (PET) for limited area imaging <1% 299 $12K
93227 <1% 464 $11K
27130 <1% 18 $11K
88312 <1% 720 $11K
11045 <1% 465 $11K
11043 <1% 279 $11K
47562 <1% 31 $10K
76536 <1% 519 $10K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 519 $10K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 538 $10K
99220 <1% 128 $10K
93793 <1% 1,797 $10K
99253 <1% 165 $10K
71250 <1% 304 $10K
95816 <1% 322 $9K
43235 <1% 128 $9K
76642 <1% 402 $9K
99468 <1% 13 $9K
88304 <1% 821 $9K
01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery <1% 54 $8K
95886 <1% 359 $8K
99479 Subsequent intensive care, per day, very low birth weight infant <1% 93 $8K
64615 <1% 90 $8K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 227 $7K
98926 <1% 285 $7K
93295 <1% 324 $7K
77066 Tomosynthesis, mammo <1% 220 $7K
92134 <1% 213 $7K
76770 <1% 274 $6K
73630 <1% 1,058 $6K
00813 <1% 167 $6K
99442 <1% 238 $6K
93880 <1% 488 $6K
73221 <1% 138 $6K
93923 <1% 338 $6K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 194 $5K
70551 Magnetic resonance imaging, brain; without contrast material <1% 132 $5K
99462 <1% 228 $5K
95251 <1% 364 $5K
73560 <1% 1,008 $5K
77065 Tomosynthesis, mammo <1% 209 $5K
99385 <1% 70 $5K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 43 $4K
73502 <1% 720 $4K
94726 <1% 651 $4K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 117 $4K
94010 <1% 496 $4K
54150 <1% 53 $4K
73130 <1% 640 $4K
99225 <1% 160 $4K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 335 $3K
77062 <1% 89 $3K
74018 <1% 598 $3K
90945 <1% 65 $3K
95811 <1% 32 $3K
76942 <1% 173 $3K
71275 Computed tomographic angiography, chest, with contrast material <1% 103 $3K
29881 <1% 28 $3K
93312 <1% 57 $3K
73030 <1% 497 $3K
69210 <1% 219 $3K
42821 <1% 16 $3K
52000 <1% 55 $3K
94729 <1% 625 $3K
90961 <1% 40 $3K
72125 Computed tomography, cervical spine; without contrast material <1% 72 $3K
93308 <1% 118 $2K
20551 <1% 106 $2K
93000 <1% 73 $2K
93971 <1% 155 $2K
73610 <1% 407 $2K
95885 <1% 116 $2K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 178 $2K
72100 <1% 300 $2K
72131 <1% 67 $2K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 42 $2K
99252 <1% 61 $2K
73562 <1% 332 $2K
00142 <1% 65 $2K
74240 <1% 67 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 66 $2K
11102 <1% 99 $2K
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% 2,575 $2K
94060 <1% 141 $2K
74178 <1% 28 $2K
58300 <1% 42 $2K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 138 $1K
00812 <1% 40 $1K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 139 $1K
31624 <1% 18 $1K
76820 <1% 62 $1K
75574 <1% 14 $1K
10005 <1% 43 $1K
43450 <1% 56 $1K
99218 <1% 25 $1K
77263 <1% 16 $1K
01922 <1% 32 $1K
90834 Psychotherapy session, about 45 minutes <1% 22 $1K
95911 <1% 18 $1K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) <1% 57 $943.23
99406 <1% 173 $939.59
76801 <1% 30 $938.96
72202 <1% 134 $911.39
93925 <1% 60 $897.14
99254 <1% 16 $877.20
31500 <1% 16 $875.22
77300 <1% 16 $857.98
71271 <1% 33 $847.73
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory <1% 86 $831.49
99443 <1% 16 $799.40
93325 <1% 67 $762.58
76818 <1% 22 $747.51
64447 <1% 31 $728.17
70496 <1% 12 $713.19
73521 <1% 89 $663.07
20550 <1% 27 $622.46
93272 <1% 31 $609.29
99242 <1% 16 $584.18
93321 <1% 75 $495.94
00126 <1% 12 $493.38
98925 <1% 28 $485.32
93320 <1% 28 $446.01
76937 <1% 37 $399.78
73110 <1% 83 $398.56
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 88 $385.76
36556 <1% 14 $353.60
72040 <1% 44 $347.21
93297 <1% 15 $308.11
74420 <1% 26 $306.49
74220 <1% 25 $303.85
78306 <1% 15 $296.89
99441 <1% 34 $285.15
93228 <1% 14 $247.91
77002 <1% 19 $246.96
92015 Determination of refractive state <1% 78 $243.04
85060 <1% 19 $217.24
17110 <1% 17 $198.18
00811 <1% 16 $175.01
93291 <1% 13 $131.03
72170 <1% 31 $126.64
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 12 $115.35
G0250 Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests <1% 51 $114.24
76519 <1% 13 $111.45
73120 <1% 13 $96.00
11055 <1% 12 $91.96
77080 <1% 12 $44.09
81003 <1% 15 $3.38
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 0% 2,086 $0.00
99024 0% 408 $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 officialHAGY, MICHELLE (CFO)
Parent organizationPIKEVILLE MEDICAL CENTER INC.
Same official

Other billing entities under HAGY, MICHELLE

Full network →
ProviderLocationPaid
Pikeville Medical Center INCPikeville, KY$181.38M
Pikeville Medical Center INC.Pikeville, KY$1.25M
Pikeville Medical Center INC.Pikeville, KY$809K
Pikeville Medical Center, INC. (Pikeville Family Practice Clinic)Pikeville, KY$424K
Pikeville Medical Center INCPikeville, KY$160K
Pikeville Medical Center INCPikeville, KY$155K
Pikeville Medical Center, INC.Pikeville, KY$62K
Pikeville Medical Center, INC.Grundy, VA$749.26
Pikeville Medical Center, INC.Pikeville, KY$0.00

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.