Medicaid Provider Spending

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

ST CLAIRE MEDICAL CENTER, INC.,

NPI: 1801395520 · MOREHEAD, KY 40351 · Family Medicine Physician · NPI assigned 02/08/2018

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

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

$2.42M
Total Medicaid Paid
95,573
Total Claims
85,240
Beneficiaries
57
Codes Billed
2020-07
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLLOYD, DONALD (CEO/PRESIDENT)
NPI Enumeration Date02/08/2018

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 $3.31M
ST CLAIRE MEDICAL CENTER, INC MOREHEAD KY $3.29M
ST. CLAIRE MEDICAL CENTER, INC MOREHEAD KY $3.11M
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
2020 2,276 $50K
2021 11,780 $276K
2022 20,006 $539K
2023 28,919 $904K
2024 32,592 $654K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 26,641 23,690 $854K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 13,687 12,493 $350K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 5,121 4,855 $310K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 4,225 3,958 $163K
20610 3,713 2,831 $102K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2,577 2,408 $95K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 806 723 $69K
43775 71 64 $60K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2,246 1,350 $56K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 334 311 $47K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 5,542 5,195 $29K
99215 Prolong outpt/office vis 676 611 $28K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 652 620 $26K
95806 307 289 $26K
93016 1,274 1,214 $23K
93458 122 100 $20K
93018 1,271 1,212 $18K
45380 Colonoscopy, flexible; with biopsy, single or multiple 135 127 $14K
27096 52 51 $13K
95811 125 121 $13K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 896 805 $13K
94060 738 711 $11K
99233 Prolong inpt eval add15 m 275 90 $9K
93228 516 496 $8K
99223 Prolong inpt eval add15 m 137 118 $7K
99442 120 101 $6K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 73 27 $6K
11721 510 481 $5K
99205 Prolong outpt/office vis 66 60 $5K
99244 Office or other outpatient consultation, moderate to high complexity 46 43 $5K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 50 48 $5K
94726 584 563 $5K
94729 662 638 $4K
95816 101 95 $3K
99232 Subsequent hospital care, per day, moderate complexity 175 94 $3K
99152 301 260 $2K
11750 28 24 $2K
99406 274 255 $2K
93227 34 31 $805.65
94618 66 62 $775.51
99153 Mod sedat endo service >5yrs 170 151 $756.10
99222 Initial hospital care, per day, moderate complexity 15 12 $659.12
52000 12 12 $651.51
76942 28 27 $607.18
11043 13 12 $559.19
95251 41 41 $502.24
20552 17 17 $458.27
99350 Prolong home eval add 15m 15 14 $337.86
11730 14 14 $324.38
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 12 12 $289.51
74420 19 18 $185.94
1126F 10,546 9,695 $39.30
11056 13 12 $32.66
1125F 6,277 5,512 $25.18
1159F 152 146 $0.02
1160F 152 146 $0.02
99024 2,848 2,174 $0.01