Clinic
Bates Miller & Sims PLLC
Bates Miller & Sims PLLC was paid $3.23M by Medicaid between Jan 2018 and Dec 2024, across 44 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 59% of everything it billed.
33Billing provider infoBATES MILLER & SIMS PLLC
STANFORD, KY 40484
STANFORD, KY 40484
33aNPI1598869638assigned 09/11/2006
33bProvider typeRural Health Clinic/Center
28Total paid$3.23M
24GClaims128,184
24DCodes billed44
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Kentucky
Rank by total paid#19 of 265
Median peer was paid$400K
This provider vs. median8.1×
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 MILLER, JAMES controls 13+ related entities in our dataset. Read more
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 | 23,112 | $540K | |
| 2019 | 19,192 | $469K | |
| 2020 | 17,578 | $447K | |
| 2021 | 20,625 | $535K | |
| 2022 | 18,863 | $455K | |
| 2023 | 16,935 | $444K | |
| 2024incomplete | 11,879 | $335K |
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 | 59% | 58,838 | 47,592 | $1.91M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 10% | 5,254 | 4,777 | $330K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.5% | 2,453 | 2,379 | $176K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.5% | 6,464 | 5,509 | $144K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.8% | 8,101 | 7,753 | $123K |
| 90461 | 3.3% | 4,959 | 4,738 | $105K | |
| 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 | 2.7% | 1,782 | 1,639 | $86K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.5% | 1,054 | 953 | $47K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 1.4% | 918 | 836 | $45K |
| 99460 | 1.2% | 969 | 879 | $39K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 1.0% | 487 | 454 | $34K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 476 | 449 | $30K |
32 more codes
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 608 | $23K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 303 | $17K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 904 | $16K |
| 76801 | <1% | 348 | $15K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 801 | $14K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 670 | $14K |
| 81002 | <1% | 19,119 | $12K | |
| 90686 | <1% | 1,141 | $7K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 288 | $6K |
| 87428 | <1% | 86 | $4K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 53 | $4K |
| 99462 | <1% | 153 | $4K | |
| 90670 | <1% | 2,719 | $3K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 61 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 222 | $3K |
| 90633 | <1% | 1,854 | $2K | |
| 90715 | <1% | 58 | $1K | |
| 87449 | <1% | 153 | $1K | |
| 90723 | <1% | 2,216 | $1K | |
| 90632 | <1% | 38 | $1K | |
| 81025 | <1% | 143 | $1K | |
| 90648 | <1% | 2,159 | $891.91 | |
| 90680 | <1% | 1,788 | $884.47 | |
| 99324 | <1% | 70 | $866.23 | |
| 54150 | <1% | 14 | $838.97 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 14 | $447.77 |
| 90677 | <1% | 225 | $284.33 | |
| 90685 | <1% | 33 | $82.28 | |
| 90710 | <1% | 127 | $36.81 | |
| 90734 | 0% | 32 | $0.00 | |
| 90651 | 0% | 16 | $0.00 | |
| 90696 | 0% | 13 | $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 officialMILLER, JAMES (MEDICAL DIRECTOR)
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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.