Community Care of West Virginia, INC.
Community Care of West Virginia, INC. was paid $4.12M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 89% of everything it billed.
SUTTON, WV 26601
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 7,923 | $547K | |
| 2019 | 4,007 | $269K | |
| 2020 | 6,590 | $369K | |
| 2021 | 9,590 | $535K | |
| 2022 | 15,193 | $1.16M | |
| 2023 | 13,809 | $970K | |
| 2024incomplete | 2,397 | $263K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 89% | 22,597 | 18,561 | $3.65M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.5% | 18,933 | 15,674 | $225K |
| 87428 | 1.8% | 2,381 | 2,216 | $74K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.6% | 2,068 | 1,864 | $66K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 4,764 | 4,022 | $40K |
| 81003 | <1% | 976 | 883 | $17K | |
| 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 | <1% | 1,058 | 792 | $14K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 653 | 598 | $13K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 285 | 268 | $9K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 100 | 86 | $3K |
| 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% | 401 | 368 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 140 | 120 | $485.26 |
14 more codes
| 81025 | <1% | 52 | $304.46 | |
| 99000 | <1% | 1,157 | $157.45 | |
| 3074F | 0% | 831 | $0.00 | |
| 1036F | 0% | 159 | $0.00 | |
| 1125F | 0% | 68 | $0.00 | |
| 87807 | 0% | 54 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 36 | $0.00 |
| 1126F | 0% | 15 | $0.00 | |
| 1034F | 0% | 15 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 0% | 13 | $0.00 |
| 3078F | 0% | 791 | $0.00 | |
| 1160F | 0% | 743 | $0.00 | |
| 1159F | 0% | 741 | $0.00 | |
| 80305 | 0% | 478 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.