Clinic
Community Care of West Virginia, INC.
Community Care of West Virginia, INC. was paid $7.68M by Medicaid between Jan 2018 and Nov 2024, across 51 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.
ROCK CAVE, WV 26234
ROCK CAVE, WV 26234
33aNPI1912932526assigned 07/11/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$7.68M
24GClaims100,930
24DCodes billed51
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
Rank by total paid#18 of 205
Median peer was paid$521K
This provider vs. median15×
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
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 | 13,874 | $913K | |
| 2019 | 5,771 | $400K | |
| 2020 | 14,684 | $924K | |
| 2021 | 18,039 | $1.22M | |
| 2022 | 21,917 | $1.90M | |
| 2023 | 16,285 | $1.57M | |
| 2024incomplete | 10,360 | $761K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 91% | 44,979 | 36,154 | $6.97M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.0% | 21,656 | 18,574 | $309K |
| 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 | 1.3% | 8,090 | 7,093 | $102K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,051 | 1,892 | $32K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 807 | 749 | $29K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,766 | 1,627 | $29K |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 91 | 83 | $26K |
| 87428 | <1% | 888 | 784 | $19K | |
| 92551 | <1% | 933 | 918 | $18K | |
| 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% | 3,018 | 2,279 | $16K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 446 | 435 | $16K |
| 90686 | <1% | 797 | 721 | $15K |
39 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 654 | $15K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 540 | $14K |
| 81002 | <1% | 628 | $14K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 383 | $11K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 225 | $9K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 394 | $7K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 284 | $6K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 321 | $4K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 467 | $4K |
| 90715 | <1% | 108 | $2K | |
| 90674 | <1% | 21 | $2K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 31 | $1K |
| 99173 | <1% | 62 | $1K | |
| 90837 | Psychotherapy session, about an hour | <1% | 1,331 | $772.55 |
| Q3014 | Telehealth originating site facility fee | <1% | 21 | $375.00 |
| 99348 | <1% | 17 | $152.23 | |
| 3078F | 0% | 1,100 | $0.00 | |
| 1159F | 0% | 1,161 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 325 | $0.00 |
| 1160F | 0% | 1,127 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 27 | $0.00 |
| 81025 | 0% | 26 | $0.00 | |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 134 | $0.00 |
| 90791 | Psychiatric diagnostic evaluation | 0% | 45 | $0.00 |
| 81003 | 0% | 14 | $0.00 | |
| 3074F | 0% | 1,570 | $0.00 | |
| 1036F | 0% | 895 | $0.00 | |
| 1126F | 0% | 717 | $0.00 | |
| 99000 | 0% | 750 | $0.00 | |
| 1125F | 0% | 737 | $0.00 | |
| 3079F | 0% | 415 | $0.00 | |
| 1034F | 0% | 268 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 412 | $0.00 |
| 3075F | 0% | 50 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 32 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 14 | $0.00 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 55 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 28 | $0.00 |
| 90656 | 0% | 19 | $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)
Parent organizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.