Physician
ST Claire Medical Center, INC.,
ST Claire Medical Center, INC., was paid $3.31M by Medicaid between Jan 2018 and Nov 2024, across 55 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.
33Billing provider infoST CLAIRE MEDICAL CENTER, INC.,
MOREHEAD, KY 40351
MOREHEAD, KY 40351
33aNPI1740581198assigned 11/16/2010
33bProvider typeFamily Medicine Physician
28Total paid$3.31M
24GClaims93,407
24DCodes billed55
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in Kentucky
Rank by total paid#21 of 352
Median peer was paid$90K
This provider vs. median37×
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 LLOYD, DONALD 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 | |
|---|---|---|---|
| 2018 | 19,616 | $655K | |
| 2019 | 23,374 | $701K | |
| 2020 | 16,988 | $577K | |
| 2021 | 15,174 | $583K | |
| 2022 | 9,839 | $432K | |
| 2023 | 4,294 | $196K | |
| 2024incomplete | 4,122 | $163K |
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 | 24% | 24,527 | 22,214 | $784K |
| 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 | 23% | 22,432 | 19,195 | $748K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.8% | 4,875 | 4,540 | $259K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.9% | 3,993 | 3,833 | $228K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 4.9% | 1,900 | 1,676 | $162K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 4.5% | 4,392 | 4,020 | $147K |
| 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 | 3.8% | 1,876 | 1,724 | $125K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 3.3% | 527 | 489 | $110K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.1% | 2,563 | 674 | $70K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 2.0% | 421 | 392 | $67K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.7% | 1,057 | 970 | $55K |
| 95811 | 1.6% | 520 | 491 | $52K |
43 more codes
| 99215 | Doctor's office visit, returning patient (complex) | 1.4% | 1,010 | $46K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 1.2% | 346 | $39K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 1.1% | 1,025 | $36K |
| 95806 | 1.1% | 422 | $36K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,550 | $32K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 5,833 | $26K |
| 94060 | <1% | 1,780 | $23K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 486 | $23K |
| 93016 | <1% | 1,434 | $22K | |
| 93458 | <1% | 142 | $22K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 320 | $22K |
| 99441 | <1% | 931 | $20K | |
| 99443 | <1% | 315 | $19K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 139 | $19K |
| 93018 | <1% | 1,413 | $18K | |
| 99442 | <1% | 285 | $12K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 188 | $11K |
| 94726 | <1% | 1,431 | $10K | |
| 27096 | <1% | 52 | $9K | |
| 94729 | <1% | 1,526 | $7K | |
| 45384 | <1% | 41 | $7K | |
| 99406 | <1% | 949 | $5K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 629 | $5K |
| 99255 | <1% | 24 | $4K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 70 | $3K |
| 95816 | <1% | 93 | $3K | |
| 99205 | Prolong outpt/office vis | <1% | 27 | $3K |
| 99152 | <1% | 218 | $2K | |
| 99292 | <1% | 66 | $2K | |
| 64493 | <1% | 28 | $2K | |
| 99188 | <1% | 107 | $2K | |
| 20552 | <1% | 54 | $1K | |
| 93227 | <1% | 55 | $1K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 17 | $1K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 65 | $888.26 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 97 | $816.98 |
| 98927 | <1% | 18 | $664.81 | |
| 99381 | <1% | 14 | $653.22 | |
| 99349 | <1% | 28 | $621.67 | |
| 76942 | <1% | 16 | $216.17 | |
| 99153 | Mod sedat endo service >5yrs | <1% | 92 | $154.94 |
| 96127 | <1% | 71 | $110.67 | |
| 1126F | <1% | 917 | $4.23 |
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 officialLLOYD, DONALD (CEO/PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| ST Claire Medical Center INC | Morehead, KY | $71.27M |
| ST Claire Medical Center INC. | Morehead, KY | $4.05M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.32M |
| ST Claire Medical Center, INC | Morehead, KY | $3.29M |
| ST. Claire Medical Center, INC | Morehead, KY | $3.11M |
| ST Claire Medical Center, INC., | Morehead, KY | $2.42M |
| ST. Claire Medical Center | Morehead, KY | $2.40M |
| ST. Claire Medical Center, INC. | Morehead, KY | $2.09M |
| ST Claire Regional Radiology Physicians Services | Morehead, KY | $1.83M |
| ST Claire Medical Center, INC., | Morehead, KY | $1.46M |
| ST. Claire Medical Center,inc | Olive Hill, KY | $1.13M |
| ST. Claire Medical Center, INC | Owingsville, KY | $964K |
| ST. Claire Medical Center,inc | Sandy Hook, KY | $948K |
| ST. Claire Medical Center, INC | Frenchburg, KY | $877K |
| ST Claire Medical Center, INC | Morehead, KY | $760K |
| ST. Claire Medical Center, INC | Morehead, KY | $672K |
| ST. Claire Medical Center, INC. | Morehead, KY | $411K |
| ST. Claire Medical Center INC. | Morehead, KY | $371K |
| ST Claire Medical Center INC. | Morehead, KY | $115K |
| ST. Claire Medical Center, INC. | Morehead, KY | $20K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.