Medicaid Provider Spending

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

BIG SANDY HEALTH CARE INC

NPI: 1831661404 · PIKEVILLE, KY 41501 · Federally Qualified Health Center (FQHC) · NPI assigned 12/20/2018

$530K
Total Medicaid Paid
25,763
Total Claims
20,588
Beneficiaries
35
Codes Billed
2019-07
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHERALD, JAMES (CEO)
NPI Enumeration Date12/20/2018

Related Entities

Other providers sharing the same authorized official: HERALD, JAMES

ProviderCityStateTotal Paid
BIG SANDY HEALTH CARE INC AUXIER KY $4.57M
BIG SANDY HEALTH CARE, INC INEZ KY $2.30M
BIG SANDY HEALTH CARE INC SALYERSVILLE KY $1.99M
BIG SANDY HEALTH CARE INC GRETHEL KY $1.74M
BIG SANDY HEALTH CARE INC PIKEVILLE KY $1.73M
BIG SANDY HEALTH CARE INC SALYERSVILLE KY $1.01M
BIG SANDY HEALTH CARE INC HAROLD KY $416K
THE PATHOLOGY GROUP PC MEMPHIS TN $380K
BIG SANDY HEALTH CARE INC FREEBURN KY $114K
BIG SANDY HEALTH CARE INC PAINTSVILLE KY $48K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 2,482 $34K
2020 5,635 $119K
2021 5,875 $108K
2022 4,538 $98K
2023 4,155 $105K
2024 3,078 $66K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,276 8,179 $343K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,434 2,179 $69K
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 3,899 1,376 $32K
90832 Psychotherapy, 30 minutes with patient 582 425 $27K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 1,050 794 $11K
90792 Psychiatric diagnostic evaluation with medical services 131 126 $11K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 173 170 $8K
11721 753 559 $8K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 120 109 $5K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 116 104 $4K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 453 428 $3K
80305 326 308 $2K
83036 Hemoglobin; glycosylated (A1C) 311 301 $2K
73630 123 85 $2K
36415 Collection of venous blood by venipuncture 676 633 $1K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 17 16 $539.19
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 32 15 $401.94
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 37 35 $334.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 17 16 $216.05
G0071 Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only 68 54 $205.82
36416 24 24 $36.46
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 12 12 $23.82
J1100 Injection, dexamethasone sodium phosphate, 1 mg 24 24 $10.45
4004F 2,230 1,933 $0.62
2028F 371 330 $0.34
3074F 67 66 $0.32
3044F 57 55 $0.19
3078F 25 25 $0.12
3079F 28 28 $0.08
G8510 Screening for depression is documented as negative, a follow-up plan is not required 1,415 1,360 $0.01
1036F 113 107 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 12 12 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 700 648 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 40 37 $0.00
99307 51 15 $0.00