Medicaid Provider Spending

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

COMMUNITY CARE OF WEST VIRGINIA, INC.

NPI: 1770917577 · SUTTON, WV 26601 · Federally Qualified Health Center (FQHC) · NPI assigned 08/28/2013

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

Authorized official POTASNIK, DORA controls 20+ related entities in our dataset. Read more

$4.88M
Total Medicaid Paid
71,087
Total Claims
57,788
Beneficiaries
39
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPOTASNIK, DORA (CREDENTIALING)
Parent OrganizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
NPI Enumeration Date08/28/2013

Related Entities

Other providers sharing the same authorized official: POTASNIK, DORA

ProviderCityStateTotal Paid
COMMUNITY CARE OF WEST VIRGINIA, INC. CLARKSBURG WV $10.99M
COMMUNITY CARE OF WEST VIRGINIA, INC. BRIDGEPORT WV $9.34M
COMMUNITY CARE OF WEST VIRGINIA, INC. CLAY WV $9.10M
COMMUNITY CARE OF WEST VIRGINIA, INC. ROCK CAVE WV $7.68M
COMMUNITY CARE OF WEST VIRGINIA, INC. WESTON WV $6.33M
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $5.08M
COMMUNITY CARE OF WEST VIRGINIA, INC. WEST MILFORD WV $4.39M
COMMUNITY CARE OF WEST VIRGINIA, INC. SUTTON WV $4.12M
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $3.49M
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $3.01M
COMMUNITY CARE OF WEST VIRGINIA, INC. BRIDGEPORT WV $2.63M
COMMUNITY CARE OF WEST VIRGINIA, INC. WESTON WV $2.16M
COMMUNITY CARE OF WEST VIRGINIA, INC. IVYDALE WV $1.73M
COMMUNITY CARE OF WEST VIRGINIA, INC. MARLINTON WV $1.49M
COMMUNITY CARE OF WEST VIRGINIA, INC. CLAY WV $900K
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $865K
COMMUNITY CARE OF WEST VIRGINIA, INC. WESTON WV $599K
COMMUNITY CARE OF WEST VIRGINIA, INC. CLAY WV $251K
COMMUNITY CARE OF WEST VIRGINIA INC CLAY WV $214K
COMMUNITY CARE OF WEST VIRGINIA, INC. LUMBERPORT WV $207K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,979 $306K
2019 2,370 $127K
2020 6,561 $421K
2021 7,040 $470K
2022 8,125 $702K
2023 18,966 $1.45M
2024 23,046 $1.41M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 26,970 21,255 $4.67M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 12,204 10,043 $75K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 8,719 7,408 $66K
87428 1,824 1,667 $38K
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month 1,838 1,648 $12K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 405 367 $9K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 167 148 $5K
90674 35 35 $3K
90686 188 165 $2K
81003 118 98 $756.80
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 14 13 $550.42
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 16 12 $333.84
90472 Immunization administration, each additional vaccine (list separately) 12 12 $189.72
90837 Psychotherapy, 53 minutes with patient 361 202 $186.32
92551 28 27 $152.23
90834 Psychotherapy, 45 minutes with patient 130 74 $118.63
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,916 1,618 $100.99
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 45 40 $5.00
3078F 2,848 2,373 $0.00
1159F 2,143 1,595 $0.00
1160F 2,018 1,491 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 91 75 $0.00
3077F 31 28 $0.00
90832 Psychotherapy, 30 minutes with patient 60 31 $0.00
G0444 Annual depression screening, 5 to 15 minutes 19 15 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 61 54 $0.00
1126F 964 842 $0.00
3079F 428 352 $0.00
1125F 1,234 1,019 $0.00
3074F 2,925 2,436 $0.00
1036F 1,880 1,489 $0.00
3075F 211 174 $0.00
G0008 Administration of influenza virus vaccine 44 40 $0.00
1035F 172 153 $0.00
1034F 635 508 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 139 112 $0.00
90792 Psychiatric diagnostic evaluation with medical services 157 134 $0.00
H0004 Behavioral health counseling and therapy, per 15 minutes 19 18 $0.00
36415 Collection of venous blood by venipuncture 18 17 $0.00