Clinic
Madisonville Primary Care Group PLLC
Madisonville Primary Care Group PLLC was paid $451K by Medicaid between Jan 2018 and Dec 2024, across 14 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 93% of everything it billed.
33Billing provider infoMADISONVILLE PRIMARY CARE GROUP PLLC
MADISONVILLE, TN 37354
MADISONVILLE, TN 37354
33aNPI1861780496assigned 07/18/2011
33bProvider typePrimary Care Clinic/Center
28Total paid$451K
24GClaims13,423
24DCodes billed14
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Tennessee
Rank by total paid#30 of 139
Median peer was paid$101K
This provider vs. median4.5×
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 | 1,403 | $43K | |
| 2019 | 1,706 | $55K | |
| 2020 | 1,606 | $56K | |
| 2021 | 1,925 | $67K | |
| 2022 | 2,248 | $79K | |
| 2023 | 2,249 | $78K | |
| 2024incomplete | 2,286 | $74K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 93% | 11,272 | 8,407 | $421K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 3.2% | 537 | 389 | $15K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.7% | 764 | 373 | $8K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 1.1% | 57 | 41 | $5K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 131 | 101 | $2K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 62 | 44 | $1K |
| 36415 | Collection of venous blood by venipuncture | <1% | 212 | 178 | $319.71 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 168 | 139 | $48.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 18 | 12 | $15.40 |
| 3074F | <1% | 139 | 118 | $10.00 | |
| 3008F | 0% | 14 | 12 | $0.00 | |
| 2010F | 0% | 15 | 13 | $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 officialCAIN, GREGORY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Madisonville Primary Care Group PLLC | Etowah, TN | $11K |
| Madisonville Primary Care Group PLLC | Athens, TN | $6K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.