Holistic, INC

Holistic, INC was paid $7.98M by Medicaid between Apr 2018 and Nov 2022, across 38 billing codes. Its largest line is G0482, Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed — 22% of everything it billed.

Compared with peers

Next to other Medical Specialty Clinic/Center providers in West Virginia

Rank by total paid#1 of 16

Median peer was paid$134K

This provider vs. median60×

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	23,739	$994K
2019	22,160	$968K
2020	64,421	$2.90M
2021	48,731	$2.36M
2022	17,793	$755K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed	22%	12,745	7,538	$1.74M
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	16%	28,011	12,281	$1.30M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	16%	27,445	12,278	$1.28M
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	15%	28,552	11,045	$1.21M
82075		5.3%	14,415	6,440	$425K
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	5.0%	10,659	4,149	$401K
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	4.4%	5,579	4,372	$352K
99406		3.4%	16,540	8,215	$272K
99401		2.8%	7,642	3,898	$226K
99407		1.9%	4,656	3,866	$150K
99402		1.7%	2,854	2,175	$139K
81025		1.4%	6,522	2,984	$114K

26 more codes

86328		1.2%	2,621	$99K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed	<1%	734	$73K
90863		<1%	1,738	$30K
80305		<1%	793	$24K
90853	Group psychotherapy (other than of a multiple-family group)	<1%	1,309	$24K
90837	Psychotherapy session, about an hour	<1%	274	$23K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed	<1%	381	$19K
99204	Doctor's office visit, new patient (more involved)	<1%	204	$12K
93000		<1%	615	$9K
90834	Psychotherapy session, about 45 minutes	<1%	114	$7K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	219	$7K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	85	$6K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	73	$6K
99385		<1%	97	$5K
99203	Doctor's office visit, new patient (routine)	<1%	99	$5K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed	<1%	608	$5K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	283	$4K
H0031	Mental health assessment, by non-physician	<1%	21	$3K
93922		<1%	56	$3K
94010		<1%	118	$2K
36415	Collection of venous blood by venipuncture	<1%	392	$2K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	148	$2K
90686		<1%	37	$623.96
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	89	$510.65
90658		<1%	53	$438.02
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	<1%	63	$125.01

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 officialBLANKENSHIP, SHAWN (OWNER)