Clinic
Big Sandy Health Care INC
Big Sandy Health Care INC was paid $4.57M by Medicaid between Jan 2018 and Dec 2024, across 77 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
33Billing provider infoBIG SANDY HEALTH CARE INC
AUXIER, KY 41602
AUXIER, KY 41602
33aNPI1588606370assigned 06/13/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$4.57M
24GClaims199,517
24DCodes billed77
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Kentucky
Rank by total paid#10 of 37
Median peer was paid$1.29M
This provider vs. median3.5×
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 | 30,629 | $616K | |
| 2019 | 32,774 | $679K | |
| 2020 | 29,150 | $729K | |
| 2021 | 32,522 | $775K | |
| 2022 | 32,031 | $723K | |
| 2023 | 24,148 | $559K | |
| 2024incomplete | 18,263 | $486K |
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 | 46% | 62,673 | 48,344 | $2.12M |
| 76830 | Ultrasound, transvaginal | 6.3% | 5,476 | 5,051 | $289K |
| 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 | 4.5% | 17,747 | 7,631 | $207K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 3.8% | 316 | 280 | $175K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 3.8% | 3,732 | 2,863 | $174K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 3.6% | 2,666 | 2,487 | $166K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 2.5% | 347 | 324 | $115K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 2.5% | 1,664 | 1,538 | $113K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.5% | 3,041 | 1,161 | $113K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 2.0% | 2,060 | 1,755 | $91K |
| 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 | 2.0% | 1,692 | 1,607 | $90K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.9% | 1,127 | 1,054 | $86K |
65 more codes
| 99203 | Doctor's office visit, new patient (routine) | 1.7% | 1,540 | $80K |
| 99223 | Prolong inpt eval add15 m | 1.6% | 1,049 | $75K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.3% | 4,097 | $58K |
| 36415 | Collection of venous blood by venipuncture | 1.1% | 14,750 | $52K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.0% | 742 | $46K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 960 | $43K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 997 | $41K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 1,308 | $40K |
| 81025 | <1% | 5,899 | $38K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,591 | $38K |
| 90837 | Psychotherapy session, about an hour | <1% | 518 | $36K |
| 59025 | Fetal non-stress test | <1% | 1,519 | $34K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 444 | $32K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,915 | $28K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,646 | $22K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 562 | $22K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,927 | $19K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 538 | $19K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 279 | $18K |
| 90461 | <1% | 853 | $11K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 429 | $10K |
| 81001 | <1% | 5,025 | $6K | |
| 99220 | <1% | 74 | $6K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 123 | $6K |
| 81003 | <1% | 12,597 | $5K | |
| 82950 | <1% | 1,185 | $5K | |
| 99386 | <1% | 72 | $5K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 54 | $4K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 83 | $4K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 638 | $4K |
| 87420 | <1% | 285 | $3K | |
| 90715 | <1% | 93 | $2K | |
| 99385 | <1% | 47 | $2K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 55 | $2K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 287 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 159 | $2K |
| 99217 | <1% | 42 | $2K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 275 | $2K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 925 | $1K |
| 99173 | <1% | 31 | $770.00 | |
| 99219 | <1% | 16 | $724.43 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 12 | $707.28 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 54 | $517.40 |
| 90674 | <1% | 19 | $336.21 | |
| 4004F | <1% | 11,010 | $111.99 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 15 | $104.20 |
| 90686 | <1% | 160 | $89.53 | |
| 99177 | <1% | 41 | $84.63 | |
| 92558 | <1% | 16 | $75.79 | |
| 36416 | <1% | 70 | $74.36 | |
| 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% | 27 | $64.56 |
| 85018 | <1% | 43 | $54.04 | |
| 90633 | <1% | 27 | $18.41 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 12,224 | $11.64 |
| 1036F | <1% | 4,163 | $0.60 | |
| 3044F | <1% | 56 | $0.27 | |
| 90648 | <1% | 135 | $0.14 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | <1% | 283 | $0.13 |
| 90670 | <1% | 175 | $0.12 | |
| 90677 | <1% | 24 | $0.04 | |
| 90723 | <1% | 43 | $0.03 | |
| 90680 | <1% | 12 | $0.01 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 2,211 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 354 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 173 | $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 | 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 |
| Big Sandy Health Care INC | Harold, KY | $416K |
| 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.