Clinic
New River Health Association, INC.
New River Health Association, INC. was paid $8.27M by Medicaid between Jan 2018 and Oct 2024, across 78 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 81% of everything it billed.
33Billing provider infoNEW RIVER HEALTH ASSOCIATION, INC.
SCARBRO, WV 25917
SCARBRO, WV 25917
33aNPI1811983331assigned 09/20/2005
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$8.27M
24GClaims143,433
24DCodes billed78
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
Rank by total paid#16 of 205
Median peer was paid$521K
This provider vs. median16×
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 | 38,463 | $1.75M | |
| 2019 | 15,699 | $660K | |
| 2020 | 32,656 | $1.84M | |
| 2021 | 28,461 | $1.87M | |
| 2022 | 25,172 | $1.91M | |
| 2023 | 1,613 | $118K | |
| 2024incomplete | 1,369 | $126K |
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 | 81% | 58,534 | 41,229 | $6.68M |
| D0999 | Unspecified diagnostic procedure, by report | 6.7% | 3,526 | 3,061 | $554K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.3% | 28,894 | 22,556 | $442K |
| 36415 | Collection of venous blood by venipuncture | 1.0% | 4,784 | 4,375 | $85K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 5,483 | 2,959 | $72K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 9,375 | 8,132 | $58K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 4,517 | 4,089 | $46K |
| 80053 | Comprehensive metabolic panel | <1% | 3,966 | 3,623 | $45K |
| 80061 | Lipid panel | <1% | 2,089 | 1,935 | $33K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,718 | 1,579 | $23K |
| 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% | 1,413 | 1,257 | $21K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,680 | 1,581 | $20K |
66 more codes
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,277 | $17K |
| 81003 | <1% | 1,371 | $16K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,036 | $13K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 1,877 | $13K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 690 | $12K |
| 80050 | General health panel | <1% | 365 | $12K |
| 98940 | <1% | 525 | $9K | |
| 0002A | <1% | 463 | $8K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 709 | $8K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 260 | $7K |
| 90686 | <1% | 465 | $7K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 965 | $6K |
| 0001A | <1% | 456 | $6K | |
| 84439 | <1% | 333 | $6K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 585 | $5K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 140 | $3K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 231 | $3K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 147 | $3K |
| 81025 | <1% | 520 | $3K | |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 244 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 155 | $3K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 98 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 140 | $2K |
| 82043 | <1% | 144 | $2K | |
| 82570 | <1% | 121 | $2K | |
| 82607 | <1% | 77 | $2K | |
| 90670 | <1% | 122 | $2K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 213 | $2K |
| 90837 | Psychotherapy session, about an hour | <1% | 61 | $1K |
| 90715 | <1% | 105 | $1K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 45 | $1K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 21 | $753.60 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 15 | $661.85 |
| 80305 | <1% | 69 | $653.53 | |
| 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% | 104 | $610.33 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 24 | $513.64 |
| D1120 | Dental cleaning, child | <1% | 81 | $482.88 |
| 86803 | <1% | 24 | $447.37 | |
| 90633 | <1% | 42 | $437.29 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 130 | $362.16 |
| D0140 | Limited oral evaluation - problem focused | <1% | 811 | $242.56 |
| 90698 | <1% | 40 | $241.44 | |
| 0003A | <1% | 16 | $240.00 | |
| 81001 | <1% | 27 | $227.03 | |
| 82728 | <1% | 12 | $180.76 | |
| 83540 | <1% | 12 | $164.84 | |
| G0008 | Administration of influenza virus vaccine | <1% | 54 | $162.05 |
| 83735 | <1% | 14 | $155.21 | |
| 82947 | <1% | 15 | $143.89 | |
| 90649 | <1% | 14 | $120.72 | |
| 90662 | <1% | 30 | $69.94 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 14 | $52.65 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 540 | $33.00 |
| 90744 | 0% | 12 | $0.00 | |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 88 | $0.00 |
| D0120 | Dental checkup, returning patient | 0% | 100 | $0.00 |
| D0210 | Intraoral - complete series of radiographic images | 0% | 12 | $0.00 |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 28 | $0.00 |
| D1110 | Prophylaxis - adult | 0% | 445 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 107 | $0.00 |
| 91300 | 0% | 404 | $0.00 | |
| 90710 | 0% | 47 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 21 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 85 | $0.00 |
| 90734 | 0% | 14 | $0.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 42 | $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 officialSCHULTZ, JOHN (EXECUTIVE DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Hopkins School District | Hopkins, MN | $6.69M |
| New River Health Association, INC. | Sophia, WV | $1.89M |
| New River Health Association, INC. | Oak Hill, WV | $1.48M |
| New River Health Association, INC. | Summersville, WV | $1.31M |
| New River Health Association, INC. | Coal City, WV | $1.15M |
| New River Health Association, INC. | Coal City, WV | $355K |
| New River Health Association, INC. | Coal City, WV | $230K |
| Family First Healthcare PLLC | Weirton, WV | $33K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.