Clinic
Upper Cumberland Rural Health Clinic PLLC
Upper Cumberland Rural Health Clinic PLLC was paid $57K by Medicaid between Jun 2023 and Dec 2024, across 8 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 55% of everything it billed.
33Billing provider infoUPPER CUMBERLAND RURAL HEALTH CLINIC PLLC
SPARTA, TN 38583
SPARTA, TN 38583
33aNPI1548992423assigned 06/29/2022
33bProvider typeRural Health Clinic/Center
28Total paid$57K
24GClaims2,762
24DCodes billed8
24AFirst – last monthJun 2023 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Tennessee
Rank by total paid#60 of 96
Median peer was paid$127K
This provider vs. median0.4×
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 | |
|---|---|---|---|
| 2023 | 1,041 | $12K | |
| 2024incomplete | 1,721 | $45K |
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 | 55% | 1,763 | 1,110 | $32K |
| 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 | 27% | 614 | 396 | $15K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 8.5% | 154 | 137 | $5K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 3.3% | 24 | 24 | $2K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.2% | 29 | 28 | $2K |
| 99441 | 1.6% | 75 | 62 | $885.63 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 32 | 27 | $432.54 |
| 96127 | <1% | 71 | 61 | $189.10 |
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 officialJAIN, NAVIN (PRACTICE ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Upper Cumberland Rural Health Clinic PLLC | Crossville, TN | $13K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.