NP / PA
Pinelake Physician Practice, LLC
Pinelake Physician Practice, LLC was paid $4.61M by Medicaid between Jan 2018 and Dec 2024, across 124 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 21% of everything it billed.
33Billing provider infoPINELAKE PHYSICIAN PRACTICE, LLC
MAYFIELD, KY 42066
MAYFIELD, KY 42066
33aNPI1861563439assigned 11/13/2006
33bProvider typeNurse Practitioner
28Total paid$4.61M
24GClaims259,867
24DCodes billed124
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Nurse Practitioner providers in Kentucky
Rank by total paid#14 of 260
Median peer was paid$89K
This provider vs. median52×
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 LAWRENCE, CHARLOTTE 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 | 36,204 | $754K | |
| 2019 | 27,776 | $662K | |
| 2020 | 27,542 | $652K | |
| 2021 | 34,488 | $895K | |
| 2022 | 41,850 | $682K | |
| 2023 | 60,960 | $557K | |
| 2024incomplete | 31,047 | $413K |
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 | 21% | 40,905 | 31,182 | $976K |
| 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 | 15% | 21,495 | 17,204 | $686K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 9.4% | 8,685 | 7,261 | $433K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 7.0% | 4,322 | 3,271 | $322K |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | 5.5% | 2,878 | 2,398 | $253K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 5.2% | 4,436 | 1,128 | $239K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 4.3% | 3,795 | 3,111 | $200K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.2% | 12,976 | 2,974 | $146K |
| 99243 | 2.0% | 1,152 | 1,055 | $90K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.8% | 3,062 | 2,416 | $85K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 1.8% | 763 | 583 | $83K |
| 20610 | 1.5% | 2,958 | 1,941 | $71K |
112 more codes
| 51741 | 1.5% | 1,991 | $69K | |
| 99223 | Prolong inpt eval add15 m | 1.3% | 1,717 | $62K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.3% | 1,797 | $60K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | 1.3% | 3,266 | $58K |
| 11721 | 1.2% | 7,305 | $56K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 1.1% | 388 | $52K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.1% | 926 | $50K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.0% | 923 | $47K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.0% | 2,156 | $46K |
| 95117 | <1% | 4,899 | $39K | |
| 51798 | <1% | 4,020 | $35K | |
| 90461 | <1% | 1,272 | $32K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 4,210 | $31K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 205 | $23K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 3,297 | $20K |
| 97597 | <1% | 1,323 | $20K | |
| 99442 | <1% | 782 | $20K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 401 | $19K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 707 | $19K |
| 99205 | Prolong outpt/office vis | <1% | 232 | $19K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 4,445 | $19K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 596 | $19K |
| 93000 | <1% | 1,426 | $13K | |
| 99406 | <1% | 1,917 | $11K | |
| 59025 | Fetal non-stress test | <1% | 676 | $11K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 306 | $11K |
| 93016 | <1% | 669 | $10K | |
| 99460 | <1% | 231 | $9K | |
| 93458 | <1% | 48 | $8K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 945 | $8K |
| 93018 | <1% | 671 | $8K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 679 | $7K |
| 20550 | <1% | 186 | $7K | |
| 99221 | <1% | 628 | $6K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 94 | $6K |
| 11750 | <1% | 149 | $6K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 181 | $6K |
| 87428 | <1% | 119 | $6K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 1,345 | $6K |
| 99050 | <1% | 274 | $6K | |
| 90961 | <1% | 202 | $5K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 100 | $5K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 544 | $4K |
| 99255 | <1% | 29 | $4K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 202 | $4K |
| 36415 | Collection of venous blood by venipuncture | <1% | 948 | $3K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 74 | $3K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 171 | $3K |
| 99383 | <1% | 42 | $3K | |
| 99285 | Emergency room visit (most serious) | <1% | 31 | $3K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 53 | $3K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 14 | $2K |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | <1% | 14 | $2K |
| 90670 | <1% | 669 | $2K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 29 | $2K |
| 95115 | <1% | 848 | $2K | |
| 81003 | <1% | 3,602 | $2K | |
| 83655 | <1% | 178 | $2K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 712 | $1K |
| 90962 | <1% | 32 | $1K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 32 | $996.40 |
| 95024 | <1% | 16 | $964.90 | |
| 11100 | <1% | 40 | $795.77 | |
| 52000 | <1% | 20 | $757.55 | |
| 81025 | <1% | 123 | $726.08 | |
| 87430 | <1% | 130 | $666.69 | |
| 99307 | <1% | 427 | $624.33 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 151 | $578.84 |
| 99152 | <1% | 78 | $512.81 | |
| 90723 | <1% | 477 | $512.75 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 105 | $501.67 |
| 99336 | <1% | 57 | $439.10 | |
| 81000 | <1% | 342 | $401.20 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 13 | $359.35 |
| 87400 | <1% | 66 | $329.98 | |
| 85018 | <1% | 177 | $289.36 | |
| 90647 | <1% | 473 | $256.18 | |
| 99441 | <1% | 41 | $252.20 | |
| 90680 | <1% | 237 | $236.88 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 20 | $211.49 |
| 90633 | <1% | 246 | $185.03 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 444 | $169.95 |
| 20605 | <1% | 31 | $155.59 | |
| 81002 | <1% | 235 | $127.92 | |
| 1036F | <1% | 9,417 | $103.13 | |
| 97802 | <1% | 12 | $82.17 | |
| 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 | <1% | 21 | $70.74 |
| 90686 | <1% | 75 | $54.35 | |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | <1% | 19 | $31.11 |
| 3074F | <1% | 8,554 | $18.88 | |
| 3078F | <1% | 8,590 | $18.43 | |
| 3008F | <1% | 14,984 | $15.17 | |
| 3079F | <1% | 2,375 | $5.96 | |
| 1160F | <1% | 11,302 | $3.65 | |
| 1159F | <1% | 11,301 | $3.64 | |
| 3077F | <1% | 1,147 | $3.04 | |
| 3075F | <1% | 1,156 | $2.68 | |
| 3080F | <1% | 576 | $1.47 | |
| 1034F | <1% | 4,365 | $0.83 | |
| J2426 | Injection, paliperidone palmitate extended release (invega sustenna), 1 mg | <1% | 136 | $0.13 |
| 99334 | 0% | 42 | $0.00 | |
| 3725F | 0% | 869 | $0.00 | |
| 90734 | 0% | 78 | $0.00 | |
| 90715 | 0% | 62 | $0.00 | |
| 90707 | 0% | 26 | $0.00 | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 0% | 44 | $0.00 |
| 36416 | 0% | 160 | $0.00 | |
| 99024 | 0% | 2,805 | $0.00 | |
| 1125F | 0% | 2,318 | $0.00 | |
| 1126F | 0% | 2,046 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 57 | $0.00 |
| 90716 | 0% | 26 | $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 officialLAWRENCE, CHARLOTTE (SECRETARY)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.