Summersville Out Patient Center

Summersville Out Patient Center was paid $46K by Medicaid between Jan 2018 and Feb 2019, across 13 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 30% of everything it billed.

33Billing provider infoSUMMERSVILLE OUT PATIENT CENTER
SUMMERSVILLE, WV 26651

33aNPI1750378345assigned 09/29/2005

33bProvider typeClinical Medical Laboratory

28Total paid$46K

24GClaims2,979

24DCodes billed13

24AFirst – last monthJan 2018 – Feb 2019

Compared with peers

Next to other Clinical Medical Laboratory providers in West Virginia

Rank by total paid#20 of 36

Median peer was paid$61K

This provider vs. median0.8×

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.

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	2,817	$46K
2019	162	$444.33

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	30%	556	465	$14K
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%	207	188	$10K
81001		11%	374	298	$5K
82570		11%	373	296	$5K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	11%	58	49	$5K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	4.0%	620	437	$2K
51798		3.6%	165	128	$2K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	2.5%	12	12	$1K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	2.5%	58	48	$1K
G9903	Patient screened for tobacco use and identified as a tobacco non-user	<1%	193	126	$323.82
1036F		<1%	168	107	$323.82
G9744	Patient not eligible due to active diagnosis of hypertension	<1%	75	40	$97.66

1 more codes

G8417

Bmi is documented above normal parameters and a follow-up plan is documented

<1%

120

$64.85

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 officialHILL, DEBBIE (CEO)