Behavioral
Mercy Health Physicians Kentucky Specialty Care LLC
Mercy Health Physicians Kentucky Specialty Care LLC was paid $4.72M by Medicaid between Jan 2021 and Dec 2024, across 129 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 29% of everything it billed.
33Billing provider infoMERCY HEALTH PHYSICIANS KENTUCKY SPECIALTY CARE LLC
PADUCAH, KY 42003
PADUCAH, KY 42003
33aNPI1700408093assigned 05/11/2020
33bProvider typePsychologist
28Total paid$4.72M
24GClaims229,198
24DCodes billed129
24AFirst – last monthJan 2021 – Dec 2024
Compared with peers
Next to other Psychologist providers in Kentucky
Rank by total paid#9 of 40
Median peer was paid$395K
This provider vs. median12×
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 RALSTON, KIMBERLY 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 | |
|---|---|---|---|
| 2021 | 43,728 | $805K | |
| 2022 | 65,046 | $1.19M | |
| 2023 | 70,067 | $1.47M | |
| 2024incomplete | 50,357 | $1.27M |
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 | 29% | 52,650 | 42,343 | $1.36M |
| 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 | 22% | 29,315 | 25,465 | $1.03M |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 6.0% | 4,777 | 4,042 | $285K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.2% | 3,838 | 3,169 | $149K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 3.0% | 2,087 | 1,624 | $142K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.6% | 18,578 | 14,821 | $121K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.5% | 10,454 | 4,709 | $119K |
| 99223 | Prolong inpt eval add15 m | 2.4% | 1,400 | 1,210 | $115K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.3% | 9,623 | 8,666 | $106K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2.1% | 2,881 | 2,549 | $99K |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.8% | 1,628 | 1,427 | $86K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.8% | 1,113 | 1,002 | $84K |
117 more codes
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 1.8% | 777 | $83K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 1.7% | 167 | $81K |
| 95806 | 1.7% | 1,008 | $79K | |
| 99232 | Hospital visit by a doctor, follow-up day | 1.5% | 2,663 | $73K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | 1.3% | 1,664 | $59K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 389 | $42K |
| 90837 | Psychotherapy session, about an hour | <1% | 647 | $35K |
| 95886 | <1% | 543 | $31K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 593 | $29K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 819 | $28K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 566 | $26K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 471 | $25K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 243 | $25K |
| 97597 | <1% | 1,657 | $25K | |
| 20553 | <1% | 1,616 | $24K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,396 | $22K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 682 | $20K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 147 | $19K |
| 99443 | <1% | 430 | $19K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,228 | $18K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 399 | $16K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 250 | $16K |
| 92567 | <1% | 2,000 | $14K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 138 | $13K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 620 | $13K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,652 | $11K |
| 64615 | <1% | 139 | $10K | |
| 76942 | <1% | 598 | $10K | |
| 92587 | <1% | 507 | $10K | |
| 93000 | <1% | 832 | $9K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 509 | $9K |
| 99254 | <1% | 79 | $8K | |
| 99243 | <1% | 118 | $7K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 248 | $7K |
| 93923 | <1% | 393 | $7K | |
| 93971 | <1% | 476 | $6K | |
| 64405 | <1% | 175 | $6K | |
| 20611 | <1% | 218 | $5K | |
| 76830 | Ultrasound, transvaginal | <1% | 216 | $5K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 108 | $5K |
| 99205 | Prolong outpt/office vis | <1% | 66 | $4K |
| 99442 | <1% | 139 | $4K | |
| 92553 | <1% | 236 | $4K | |
| 99242 | <1% | 64 | $3K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 67 | $3K |
| 94060 | <1% | 228 | $3K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 506 | $3K |
| 93880 | <1% | 198 | $3K | |
| 93016 | <1% | 240 | $3K | |
| 99253 | <1% | 38 | $3K | |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | <1% | 12 | $2K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 128 | $2K |
| 76642 | <1% | 118 | $2K | |
| 93018 | <1% | 242 | $2K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 94 | $2K |
| 51798 | <1% | 339 | $2K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 80 | $2K |
| 43450 | <1% | 123 | $2K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 37 | $2K |
| 81025 | <1% | 280 | $2K | |
| 20610 | <1% | 47 | $2K | |
| 69210 | <1% | 185 | $2K | |
| 64450 | <1% | 108 | $2K | |
| 94726 | <1% | 244 | $2K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 17 | $2K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 122 | $2K |
| 94729 | <1% | 343 | $2K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 49 | $2K |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 41 | $1K |
| 93458 | <1% | 13 | $1K | |
| 93970 | <1% | 81 | $1K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 38 | $1K |
| 20552 | <1% | 94 | $937.65 | |
| 92552 | <1% | 114 | $819.99 | |
| 98968 | <1% | 70 | $799.40 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 560 | $643.44 |
| 95909 | <1% | 12 | $625.08 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 34 | $552.97 |
| 31575 | <1% | 15 | $526.24 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 528 | $467.43 |
| 99221 | <1% | 12 | $436.71 | |
| 81002 | <1% | 725 | $414.74 | |
| 74018 | <1% | 84 | $405.60 | |
| 77066 | Tomosynthesis, mammo | <1% | 14 | $392.99 |
| 87807 | <1% | 33 | $381.75 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 31 | $351.23 |
| G2066 | Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results | <1% | 32 | $349.57 |
| 77065 | Tomosynthesis, mammo | <1% | 16 | $343.95 |
| 93298 | <1% | 32 | $332.89 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 13 | $318.01 |
| 95816 | <1% | 18 | $308.99 | |
| 73030 | <1% | 55 | $272.61 | |
| 73630 | <1% | 19 | $271.68 | |
| 94618 | <1% | 28 | $252.10 | |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 13 | $231.74 |
| 94727 | <1% | 26 | $220.96 | |
| 99406 | <1% | 33 | $208.20 | |
| 76536 | <1% | 12 | $190.16 | |
| 73560 | <1% | 36 | $162.28 | |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 18 | $153.43 |
| 81001 | <1% | 184 | $152.79 | |
| 72100 | <1% | 26 | $120.04 | |
| 93356 | <1% | 15 | $107.12 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 15 | $52.76 |
| 81003 | <1% | 64 | $27.11 | |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 15,277 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 20,409 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 5,697 | $0.00 |
| 4004F | 0% | 342 | $0.00 | |
| 3078F | 0% | 13 | $0.00 | |
| 3017F | 0% | 1,399 | $0.00 | |
| 1036F | 0% | 10,409 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 108 | $0.00 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 725 | $0.00 |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 542 | $0.00 |
| 99024 | 0% | 35 | $0.00 | |
| 3074F | 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 officialRALSTON, KIMBERLY (SYSTEM DIRECTOR)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.