NP / PA
ST Claire Medical Center, INC.,
ST Claire Medical Center, INC., was paid $1.46M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is 99284, emergency room visit (serious) — 24% of everything it billed.
33Billing provider infoST CLAIRE MEDICAL CENTER, INC.,
MOREHEAD, KY 40351
MOREHEAD, KY 40351
33aNPI1821168535assigned 11/09/2006
33bProvider typePhysician Assistant
28Total paid$1.46M
24GClaims68,666
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Physician Assistant providers in Kentucky
Rank by total paid#40 of 214
Median peer was paid$134K
This provider vs. median11×
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 LLOYD, DONALD 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 | 6,466 | $134K | |
| 2019 | 9,025 | $163K | |
| 2020 | 9,509 | $182K | |
| 2021 | 11,973 | $225K | |
| 2022 | 11,777 | $253K | |
| 2023 | 11,654 | $297K | |
| 2024incomplete | 8,262 | $207K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 24% | 7,465 | 6,973 | $353K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 18% | 7,092 | 6,456 | $262K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 15% | 33,754 | 22,501 | $221K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 10% | 8,101 | 3,082 | $148K |
| 99223 | Prolong inpt eval add15 m | 7.8% | 1,802 | 1,566 | $114K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 7.2% | 1,412 | 1,318 | $105K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 4.7% | 2,296 | 2,138 | $68K |
| 99238 | Hospital discharge day management, 30 minutes or less | 4.1% | 2,159 | 1,834 | $60K |
| 99222 | Initial hospital care, per day, moderate complexity | 2.1% | 762 | 625 | $31K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.9% | 983 | 367 | $28K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.3% | 536 | 428 | $18K |
| 88307 | 1.2% | 333 | 303 | $17K |
14 more codes
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 290 | $10K |
| 88304 | <1% | 1,051 | $8K | |
| 00142 | <1% | 147 | $4K | |
| 00731 | <1% | 40 | $3K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 135 | $3K |
| 00170 | Anesthesia for intraoral procedures, including biopsy | <1% | 15 | $2K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 102 | $1K |
| 88312 | <1% | 68 | $1K | |
| 99217 | <1% | 18 | $591.07 | |
| 00813 | <1% | 16 | $543.92 | |
| 88141 | <1% | 42 | $527.29 | |
| 99219 | <1% | 13 | $456.22 | |
| 76942 | <1% | 15 | $264.45 | |
| 0011A | <1% | 19 | $216.00 |
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 officialLLOYD, DONALD (CEO/PRESIDENT)
Parent organizationST CLAIRE MEDICAL CENTER, INC.,
| Provider | Location | 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, INC., | Morehead, KY | $2.42M |
| 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 | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.