Clinic
Big Sandy Health Care INC
Big Sandy Health Care INC was paid $416K by Medicaid between Sep 2022 and Dec 2024, across 47 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.
33Billing provider infoBIG SANDY HEALTH CARE INC
HAROLD, KY 41635
HAROLD, KY 41635
33aNPI1528787199assigned 08/25/2022
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$416K
24GClaims15,813
24DCodes billed47
24AFirst – last monthSep 2022 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Kentucky
Rank by total paid#25 of 37
Median peer was paid$1.29M
This provider vs. median0.3×
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 | |
|---|---|---|---|
| 2022 | 1,122 | $19K | |
| 2023 | 7,825 | $217K | |
| 2024incomplete | 6,866 | $181K |
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 | 37% | 4,720 | 4,044 | $155K |
| 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 | 21% | 1,661 | 1,531 | $88K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 13% | 157 | 146 | $52K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 7.8% | 991 | 905 | $32K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 4.9% | 1,339 | 698 | $20K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 3.7% | 251 | 243 | $15K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 3.6% | 1,135 | 1,012 | $15K |
| V2020 | Frames, purchases | <1% | 187 | 185 | $4K |
| 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 | <1% | 288 | 110 | $3K |
| 99173 | <1% | 104 | 98 | $3K | |
| 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 | <1% | 55 | 52 | $3K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | <1% | 437 | 422 | $2K |
35 more codes
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 324 | $2K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 426 | $2K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 357 | $2K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 31 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 18 | $2K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 27 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 77 | $1K |
| 92015 | Determination of refractive state | <1% | 390 | $1K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,112 | $1K |
| 90674 | <1% | 56 | $1K | |
| 80305 | <1% | 132 | $997.52 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 12 | $942.96 |
| 90461 | <1% | 78 | $811.60 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 31 | $800.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 64 | $608.00 |
| 99460 | <1% | 13 | $597.87 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 16 | $460.81 |
| 90661 | <1% | 14 | $403.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 27 | $402.30 |
| 92558 | <1% | 28 | $186.51 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 14 | $186.48 |
| 92551 | <1% | 15 | $139.60 | |
| 87420 | <1% | 12 | $139.10 | |
| 99177 | <1% | 29 | $59.15 | |
| 3044F | <1% | 57 | $0.28 | |
| 3078F | <1% | 58 | $0.25 | |
| 3074F | <1% | 58 | $0.25 | |
| 3075F | <1% | 38 | $0.23 | |
| 3079F | <1% | 15 | $0.08 | |
| 1036F | <1% | 100 | $0.06 | |
| 90686 | <1% | 27 | $0.01 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 260 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 28 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 531 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 13 | $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 officialHERALD, JAMES (CEO)
| Provider | Location | Paid |
|---|---|---|
| Big Sandy Health Care INC | Auxier, KY | $4.57M |
| Big Sandy Health Care, INC | Inez, KY | $2.30M |
| Big Sandy Health Care INC | Salyersville, KY | $1.99M |
| Big Sandy Health Care INC | Grethel, KY | $1.74M |
| Big Sandy Health Care INC | Pikeville, KY | $1.73M |
| Big Sandy Health Care INC | Salyersville, KY | $1.01M |
| Big Sandy Health Care INC | Pikeville, KY | $530K |
| The Pathology Group PC | Memphis, TN | $380K |
| Big Sandy Health Care INC | Freeburn, KY | $114K |
| Big Sandy Health Care INC | Paintsville, KY | $48K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.