Physician
South Main Clinic LLC
South Main Clinic LLC was paid $55K by Medicaid between Jan 2020 and Jan 2023, across 9 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 64% of everything it billed.
33Billing provider infoSOUTH MAIN CLINIC LLC
MADISONVILLE, KY 42431
MADISONVILLE, KY 42431
33aNPI1851959217assigned 05/31/2019
33bProvider typeFamily Medicine Physician
28Total paid$55K
24GClaims2,844
24DCodes billed9
24AFirst – last monthJan 2020 – Jan 2023
Compared with peers
Next to other Family Medicine Physician providers in Kentucky
Rank by total paid#205 of 352
Median peer was paid$90K
This provider vs. median0.6×
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 | |
|---|---|---|---|
| 2020 | 276 | $7K | |
| 2021 | 1,913 | $29K | |
| 2022 | 635 | $18K | |
| 2023 | 20 | $672.98 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 64% | 1,469 | 989 | $35K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7.9% | 321 | 157 | $4K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 7.3% | 96 | 84 | $4K |
| 87428 | 6.3% | 119 | 54 | $3K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 6.2% | 331 | 205 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 4.9% | 110 | 81 | $3K |
| 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 | 2.6% | 38 | 27 | $1K |
| 80305 | <1% | 42 | 28 | $334.49 | |
| 99072 | <1% | 318 | 123 | $35.00 |
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 officialASHBY, JAMES (VICE-PRESIDENT/MEMBER)