NP / PA
Cumberland Gi, PSC
Cumberland Gi, PSC was paid $920K by Medicaid between Jan 2018 and Dec 2024, across 16 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 37% of everything it billed.
33Billing provider infoCUMBERLAND GI, PSC
CORBIN, KY 40701
CORBIN, KY 40701
33aNPI1578557708assigned 09/02/2005
33bProvider typeNurse Practitioner
28Total paid$920K
24GClaims10,314
24DCodes billed16
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Nurse Practitioner providers in Kentucky
Rank by total paid#42 of 260
Median peer was paid$89K
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 | |
|---|---|---|---|
| 2018 | 1,622 | $122K | |
| 2019 | 1,691 | $145K | |
| 2020 | 1,721 | $145K | |
| 2021 | 1,786 | $173K | |
| 2022 | 1,432 | $140K | |
| 2023 | 1,253 | $130K | |
| 2024incomplete | 809 | $66K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 37% | 1,618 | 1,325 | $338K |
| 99443 | 25% | 4,306 | 3,965 | $228K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 17% | 717 | 586 | $159K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 7.4% | 226 | 185 | $68K |
| 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 | 3.0% | 793 | 728 | $28K |
| 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 | 2.7% | 370 | 349 | $25K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 2.0% | 192 | 163 | $18K |
| J2704 | Injection, propofol, 10 mg | 1.5% | 528 | 459 | $14K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.3% | 581 | 524 | $12K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.2% | 291 | 271 | $11K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 255 | 227 | $7K |
| 99442 | <1% | 150 | 146 | $6K |
4 more codes
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 officialSIMONS, MICHAEL (OWNER/PRESIDENT)