Physician
Regional Health Care Affiliates, INC.
Regional Health Care Affiliates, INC. was paid $5.70M by Medicaid between Jan 2018 and Dec 2024, across 68 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 54% of everything it billed.
33Billing provider infoREGIONAL HEALTH CARE AFFILIATES, INC.
PROVIDENCE, KY 42450
PROVIDENCE, KY 42450
33aNPI1558692558assigned 01/15/2010
33bProvider typeFamily Medicine Physician
28Total paid$5.70M
24GClaims213,619
24DCodes billed68
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Kentucky
Rank by total paid#11 of 352
Median peer was paid$90K
This provider vs. median64×
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 | 27,465 | $658K | |
| 2019 | 23,803 | $620K | |
| 2020 | 25,573 | $793K | |
| 2021 | 32,275 | $932K | |
| 2022 | 34,011 | $913K | |
| 2023 | 39,247 | $973K | |
| 2024incomplete | 31,245 | $806K |
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 | 54% | 98,155 | 83,148 | $3.07M |
| 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 | 13% | 16,706 | 14,600 | $721K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 4.7% | 3,839 | 2,389 | $269K |
| 87428 | 4.5% | 7,954 | 7,107 | $257K | |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 3.1% | 4,732 | 3,597 | $174K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.1% | 2,115 | 2,076 | $119K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.9% | 2,034 | 1,982 | $111K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 1.8% | 1,206 | 1,120 | $102K |
| 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 | 1.7% | 11,251 | 4,364 | $95K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.6% | 1,508 | 1,457 | $94K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.5% | 1,689 | 1,375 | $83K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.5% | 6,129 | 5,952 | $83K |
56 more codes
| 99203 | Doctor's office visit, new patient (routine) | 1.3% | 1,381 | $73K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.2% | 1,381 | $68K |
| 90461 | 1.1% | 3,877 | $61K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 13,203 | $48K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,057 | $47K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,493 | $37K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,772 | $32K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 682 | $27K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,971 | $23K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,454 | $18K |
| 90633 | <1% | 2,115 | $13K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 278 | $11K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 189 | $11K |
| 83037 | <1% | 1,274 | $8K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 451 | $5K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 48 | $4K |
| 90686 | <1% | 1,514 | $4K | |
| 90671 | <1% | 73 | $4K | |
| 99383 | <1% | 56 | $3K | |
| 0012A | <1% | 103 | $3K | |
| 99385 | <1% | 41 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 134 | $2K |
| 99406 | <1% | 313 | $2K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 28 | $2K |
| 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% | 147 | $2K |
| 90651 | <1% | 1,217 | $2K | |
| 0011A | <1% | 105 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 121 | $989.08 |
| 81002 | <1% | 1,317 | $706.75 | |
| 90734 | <1% | 596 | $645.76 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 21 | $584.70 |
| 90756 | <1% | 38 | $562.79 | |
| 90723 | <1% | 603 | $512.72 | |
| 90670 | <1% | 1,017 | $415.44 | |
| 87807 | <1% | 30 | $331.17 | |
| 90710 | <1% | 162 | $315.28 | |
| 90674 | <1% | 19 | $281.75 | |
| 90620 | <1% | 84 | $245.91 | |
| 90688 | <1% | 36 | $226.38 | |
| 90785 | <1% | 291 | $163.79 | |
| 81000 | <1% | 65 | $127.23 | |
| 90685 | <1% | 12 | $125.10 | |
| 90715 | <1% | 364 | $91.37 | |
| 90696 | <1% | 69 | $84.00 | |
| 90621 | <1% | 15 | $71.81 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 72 | $71.76 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 34 | $63.05 |
| 90648 | <1% | 1,080 | $45.88 | |
| 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 | $23.31 |
| 36416 | <1% | 23 | $4.90 | |
| 90681 | 0% | 12 | $0.00 | |
| 90672 | 0% | 19 | $0.00 | |
| 1125F | 0% | 4,456 | $0.00 | |
| 1126F | 0% | 5,917 | $0.00 | |
| 90680 | 0% | 147 | $0.00 | |
| 90619 | 0% | 310 | $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 officialGOBIN, SHELLEY (CEO)