Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

ST CLAIRE MEDICAL CENTER, INC.,

NPI: 1740581198 · MOREHEAD, KY 40351 · Family Medicine Physician · NPI assigned 11/16/2010

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LLOYD, DONALD controls 20+ related entities in our dataset. Read more

$3.31M
Total Medicaid Paid
93,407
Total Claims
82,184
Beneficiaries
55
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLLOYD, DONALD (CEO/PRESIDENT)
NPI Enumeration Date11/16/2010

Related Entities

Other providers sharing the same authorized official: LLOYD, DONALD

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 4,122 $163K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 24,527 22,214 $784K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 22,432 19,195 $748K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 4,875 4,540 $259K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,993 3,833 $228K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,900 1,676 $162K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 4,392 4,020 $147K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,876 1,724 $125K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 527 489 $110K
99233 Prolong inpt eval add15 m 2,563 674 $70K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 421 392 $67K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,057 970 $55K
95811 520 491 $52K
99215 Prolong outpt/office vis 1,010 936 $46K
99244 Office or other outpatient consultation, moderate to high complexity 346 338 $39K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,025 963 $36K
95806 422 409 $36K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,550 1,455 $32K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 5,833 5,383 $26K
94060 1,780 1,653 $23K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 486 456 $23K
93016 1,434 1,353 $22K
93458 142 127 $22K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 320 83 $22K
99441 931 432 $20K
99443 315 287 $19K
45380 Colonoscopy, flexible; with biopsy, single or multiple 139 126 $19K
93018 1,413 1,332 $18K
99442 285 264 $12K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 188 177 $11K
94726 1,431 1,325 $10K
27096 52 50 $9K
94729 1,526 1,417 $7K
45384 41 40 $7K
99406 949 891 $5K
99309 Subsequent nursing facility care, per day, low to moderate complexity 629 552 $5K
99255 24 24 $4K
99238 Hospital discharge day management, 30 minutes or less 70 69 $3K
95816 93 88 $3K
99205 Prolong outpt/office vis 27 27 $3K
99152 218 194 $2K
99292 66 37 $2K
64493 28 26 $2K
99188 107 107 $2K
20552 54 52 $1K
93227 55 53 $1K
95810 Polysomnography; sleep staging with 4 or more additional parameters 17 16 $1K
99232 Subsequent hospital care, per day, moderate complexity 65 41 $888.26
99308 Subsequent nursing facility care, per day, straightforward 97 78 $816.98
98927 18 17 $664.81
99381 14 12 $653.22
99349 28 24 $621.67
76942 16 13 $216.17
99153 Mod sedat endo service >5yrs 92 83 $154.94
96127 71 69 $110.67
1126F 917 887 $4.23