Clinic
Pinelake Physician Practice LLC
Pinelake Physician Practice LLC was paid $236K by Medicaid between May 2019 and Jan 2021, across 24 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 65% of everything it billed.
33Billing provider infoPINELAKE PHYSICIAN PRACTICE LLC
MAYFIELD, KY 42066
MAYFIELD, KY 42066
33aNPI1679061071assigned 05/01/2018
33bProvider typeRural Health Clinic/Center
28Total paid$236K
24GClaims9,277
24DCodes billed24
24AFirst – last monthMay 2019 – Jan 2021
Compared with peers
Next to other Rural Health Clinic/Center providers in Kentucky
Rank by total paid#173 of 265
Median peer was paid$400K
This provider vs. median0.6×
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, SARA controls 20+ 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 | |
|---|---|---|---|
| 2019 | 4,084 | $86K | |
| 2020 | 5,127 | $148K | |
| 2021 | 66 | $2K |
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 | 65% | 4,896 | 3,815 | $154K |
| 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 | 18% | 926 | 606 | $42K |
| 95117 | 4.2% | 957 | 340 | $10K | |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | 3.4% | 119 | 105 | $8K |
| 36415 | Collection of venous blood by venipuncture | 1.9% | 827 | 645 | $4K |
| 99307 | 1.4% | 213 | 185 | $3K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 28 | 25 | $2K |
| 99441 | <1% | 84 | 78 | $2K | |
| 99050 | <1% | 84 | 77 | $2K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 129 | 93 | $2K |
| 99442 | <1% | 39 | 28 | $1K | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 82 | 67 | $1K |
12 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 118 | $1K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 132 | $1K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 50 | $620.37 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 22 | $440.93 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 39 | $421.72 |
| 81000 | <1% | 220 | $416.62 | |
| 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% | 69 | $336.46 |
| 95115 | <1% | 20 | $117.15 | |
| 99336 | <1% | 17 | $58.20 | |
| 81002 | <1% | 29 | $13.05 | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 0% | 102 | $0.00 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 75 | $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, SARA (DIRECTOR)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.