Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

Community Care of West Virginia, INC.

Community Care of West Virginia, INC. was paid $5.08M by Medicaid between Jan 2018 and Dec 2024, across 61 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 91% of everything it billed.

33Billing provider infoCOMMUNITY CARE OF WEST VIRGINIA, INC.
BUCKHANNON, WV 26201
33aNPI1891241030assigned 08/28/2016
28Total paid$5.08M
24GClaims90,642
24DCodes billed61
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in West Virginia

Rank by total paid#30 of 205
Median peer was paid$521K
This provider vs. median9.8×

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 POTASNIK, DORA controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$50K$100K$150K2018201920202021202220232024
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
YearClaimsPaid
201810,865$649K
20196,169$312K
202012,029$664K
202110,030$594K
202212,713$930K
202320,542$1.15M
2024incomplete18,294$782K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
T1015 A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive 91% 32,273 26,043 $4.63M
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 2.9% 15,246 12,899 $147K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2.8% 9,557 8,100 $143K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 2,503 2,212 $37K
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month <1% 3,829 3,455 $26K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 711 675 $15K
90686 <1% 950 822 $14K
G8754 Most recent diastolic blood pressure < 90 mmhg <1% 571 499 $13K
G8752 Most recent systolic blood pressure < 140 mmhg <1% 474 420 $12K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 365 324 $6K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 148 130 $6K
81002 <1% 167 149 $5K
49 more codes
90674 <1% 58 $5K
87428 <1% 158 $4K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 426 $4K
92551 <1% 205 $4K
90472 Immunization administration, each additional vaccine (list separately) <1% 351 $4K
90732 <1% 33 $940.77
90715 <1% 110 $936.21
G8753 Most recent systolic blood pressure >= 140 mmhg <1% 36 $909.02
81025 <1% 105 $507.46
99495 <1% 25 $471.91
99173 <1% 14 $304.46
90746 <1% 13 $149.19
90656 <1% 63 $118.23
92250 <1% 35 $15.22
90837 Psychotherapy session, about an hour <1% 151 $14.45
80305 0% 268 $0.00
3077F 0% 143 $0.00
1160F 0% 2,952 $0.00
3078F 0% 3,022 $0.00
1159F 0% 3,185 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 0% 55 $0.00
99203 Doctor's office visit, new patient (routine) 0% 26 $0.00
90633 0% 14 $0.00
G0444 Annual depression screening, 5 to 15 minutes 0% 107 $0.00
90662 0% 39 $0.00
91300 0% 15 $0.00
90648 0% 14 $0.00
99215 Doctor's office visit, returning patient (complex) 0% 12 $0.00
90670 0% 26 $0.00
90653 0% 20 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 0% 73 $0.00
3079F 0% 1,507 $0.00
3074F 0% 3,534 $0.00
1126F 0% 1,152 $0.00
3075F 0% 400 $0.00
1036F 0% 2,698 $0.00
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 0% 14 $0.00
1034F 0% 1,223 $0.00
1125F 0% 630 $0.00
99000 0% 65 $0.00
1035F 0% 266 $0.00
G0008 Administration of influenza virus vaccine 0% 206 $0.00
1111F 0% 14 $0.00
3044F 0% 210 $0.00
G0467 Community health center visit, returning patient 0% 29 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 0% 96 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 0% 20 $0.00
2023F 0% 14 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 0% 16 $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 officialPOTASNIK, DORA (CREDENTIALING COORDINATOR)
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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.