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

Community Care of West Virginia, INC.

Community Care of West Virginia, INC. was paid $129K by Medicaid between Mar 2018 and Nov 2024, across 13 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 97% of everything it billed.

33Billing provider infoCOMMUNITY CARE OF WEST VIRGINIA, INC.
BUCKHANNON, WV 26201
33aNPI1578811857assigned 08/17/2012
28Total paid$129K
24GClaims1,351
24DCodes billed13
24AFirst – last monthMar 2018 – Nov 2024
Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in West Virginia

Rank by total paid#140 of 205
Median peer was paid$521K
This provider vs. median0.2×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official SIMON, RICHARD controls 11+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$5.0K$10K$15K2018201920202021202220232024
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
201859$4K
2019311$33K
2020218$21K
202146$3K
2022275$19K
2023270$17K
2024incomplete172$33K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
T1015 A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive 97% 729 515 $126K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 137 121 $1K
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% 87 78 $1K
92551 <1% 103 94 $889.68
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 31 26 $211.00
90686 <1% 103 93 $23.47
90656 <1% 12 12 $17.41
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 0% 85 77 $0.00
1160F 0% 13 13 $0.00
3078F 0% 12 12 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 0% 14 14 $0.00
1159F 0% 13 13 $0.00
1 more codes
3074F 0% 12 $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 officialSIMON, RICHARD (CEO)
Parent organizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
Same official

Other billing entities under SIMON, RICHARD

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