Clinic
Community Care of West Virginia, INC.
Community Care of West Virginia, INC. was paid $4.88M by Medicaid between Jan 2018 and Dec 2024, across 39 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 96% of everything it billed.
33Billing provider infoCOMMUNITY CARE OF WEST VIRGINIA, INC.
SUTTON, WV 26601
SUTTON, WV 26601
33aNPI1770917577assigned 08/28/2013
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$4.88M
24GClaims71,087
24DCodes billed39
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
Rank by total paid#32 of 205
Median peer was paid$521K
This provider vs. median9.4×
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 POTASNIK, DORA 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 | 4,979 | $306K | |
| 2019 | 2,370 | $127K | |
| 2020 | 6,561 | $421K | |
| 2021 | 7,040 | $470K | |
| 2022 | 8,125 | $702K | |
| 2023 | 18,966 | $1.45M | |
| 2024incomplete | 23,046 | $1.41M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 96% | 26,970 | 21,255 | $4.67M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.5% | 12,204 | 10,043 | $75K |
| 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 | 1.4% | 8,719 | 7,408 | $66K |
| 87428 | <1% | 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% | 1,838 | 1,648 | $12K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 405 | 367 | $9K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 167 | 148 | $5K |
| 90674 | <1% | 35 | 35 | $3K | |
| 90686 | <1% | 188 | 165 | $2K | |
| 81003 | <1% | 118 | 98 | $756.80 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 14 | 13 | $550.42 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 16 | 12 | $333.84 |
27 more codes
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 12 | $189.72 |
| 90837 | Psychotherapy session, about an hour | <1% | 361 | $186.32 |
| 92551 | <1% | 28 | $152.23 | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 130 | $118.63 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,916 | $100.99 |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 45 | $5.00 |
| 3078F | 0% | 2,848 | $0.00 | |
| 1159F | 0% | 2,143 | $0.00 | |
| 1160F | 0% | 2,018 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 91 | $0.00 |
| 3077F | 0% | 31 | $0.00 | |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 60 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 19 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 61 | $0.00 |
| 1126F | 0% | 964 | $0.00 | |
| 3079F | 0% | 428 | $0.00 | |
| 1125F | 0% | 1,234 | $0.00 | |
| 3074F | 0% | 2,925 | $0.00 | |
| 1036F | 0% | 1,880 | $0.00 | |
| 3075F | 0% | 211 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 44 | $0.00 |
| 1035F | 0% | 172 | $0.00 | |
| 1034F | 0% | 635 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 139 | $0.00 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 0% | 157 | $0.00 |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 0% | 19 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 18 | $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.
From NPPES
Who's on the registration
Authorized officialPOTASNIK, DORA (CREDENTIALING)
Parent organizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.