Appalachian Regional Healthcare, INC.
Appalachian Regional Healthcare, INC. was paid $569K by Medicaid between Jan 2018 and Dec 2024, across 17 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 71% of everything it billed.
CUMBERLAND, KY 40823
Next to other Rural Health Clinic/Center providers in Kentucky
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 | 6,232 | $130K | |
| 2019 | 3,954 | $95K | |
| 2020 | 3,766 | $93K | |
| 2021 | 2,473 | $54K | |
| 2022 | 2,472 | $59K | |
| 2023 | 3,086 | $76K | |
| 2024incomplete | 2,240 | $62K |
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 | 71% | 16,092 | 12,549 | $406K |
| 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 | 19% | 3,456 | 2,492 | $110K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 4.0% | 1,667 | 792 | $23K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.4% | 1,140 | 1,028 | $13K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.2% | 357 | 314 | $7K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,065 | 912 | $3K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 26 | 25 | $2K |
| 90686 | <1% | 64 | 62 | $970.53 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 82 | 80 | $941.43 |
| 99442 | <1% | 45 | 44 | $717.31 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 66 | 49 | $692.76 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 18 | 18 | $680.55 |
5 more codes
| 80305 | <1% | 37 | $328.12 | |
| 72100 | <1% | 16 | $267.72 | |
| 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% | 21 | $99.60 |
| 81002 | <1% | 44 | $21.88 | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 0% | 27 | $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.