Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

COMMUNITY CARE OF WEST VIRGINIA, INC.

NPI: 1912932526 · ROCK CAVE, WV 26234 · Federally Qualified Health Center (FQHC) · NPI assigned 07/11/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official POTASNIK, DORA controls 20+ related entities in our dataset. Read more

$7.68M
Total Medicaid Paid
100,930
Total Claims
84,658
Beneficiaries
51
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialPOTASNIK, DORA (CREDENTIALING COORDINATOR)
Parent OrganizationCOMMUNITY CARE OF WEST VIRGINIA, INC.
NPI Enumeration Date07/11/2006

Related Entities

Other providers sharing the same authorized official: POTASNIK, DORA

ProviderCityStateTotal Paid
COMMUNITY CARE OF WEST VIRGINIA, INC. CLARKSBURG WV $10.99M
COMMUNITY CARE OF WEST VIRGINIA, INC. BRIDGEPORT WV $9.34M
COMMUNITY CARE OF WEST VIRGINIA, INC. CLAY WV $9.10M
COMMUNITY CARE OF WEST VIRGINIA, INC. WESTON WV $6.33M
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $5.08M
COMMUNITY CARE OF WEST VIRGINIA, INC. SUTTON WV $4.88M
COMMUNITY CARE OF WEST VIRGINIA, INC. WEST MILFORD WV $4.39M
COMMUNITY CARE OF WEST VIRGINIA, INC. SUTTON WV $4.12M
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $3.49M
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $3.01M
COMMUNITY CARE OF WEST VIRGINIA, INC. BRIDGEPORT WV $2.63M
COMMUNITY CARE OF WEST VIRGINIA, INC. WESTON WV $2.16M
COMMUNITY CARE OF WEST VIRGINIA, INC. IVYDALE WV $1.73M
COMMUNITY CARE OF WEST VIRGINIA, INC. MARLINTON WV $1.49M
COMMUNITY CARE OF WEST VIRGINIA, INC. CLAY WV $900K
COMMUNITY CARE OF WEST VIRGINIA, INC. BUCKHANNON WV $865K
COMMUNITY CARE OF WEST VIRGINIA, INC. WESTON WV $599K
COMMUNITY CARE OF WEST VIRGINIA, INC. CLAY WV $251K
COMMUNITY CARE OF WEST VIRGINIA INC CLAY WV $214K
COMMUNITY CARE OF WEST VIRGINIA, INC. LUMBERPORT WV $207K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 10,360 $761K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 44,979 36,154 $6.97M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 21,656 18,574 $309K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 8,090 7,093 $102K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,051 1,892 $32K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 807 749 $29K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,766 1,627 $29K
D0999 Unspecified diagnostic procedure, by report 91 83 $26K
87428 888 784 $19K
92551 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 3,018 2,279 $16K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 446 435 $16K
90686 797 721 $15K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 654 644 $15K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 540 513 $14K
81002 628 592 $14K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 383 364 $11K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 225 212 $9K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 394 357 $7K
90472 Immunization administration, each additional vaccine (list separately) 284 263 $6K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 321 302 $4K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 467 415 $4K
90715 108 98 $2K
90674 21 21 $2K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 31 29 $1K
99173 62 62 $1K
90837 Psychotherapy, 53 minutes with patient 1,331 705 $772.55
Q3014 Telehealth originating site facility fee 21 17 $375.00
99348 17 12 $152.23
3078F 1,100 966 $0.00
1159F 1,161 980 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 325 309 $0.00
1160F 1,127 955 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 27 26 $0.00
81025 26 26 $0.00
90832 Psychotherapy, 30 minutes with patient 134 105 $0.00
90791 Psychiatric diagnostic evaluation 45 45 $0.00
81003 14 14 $0.00
3074F 1,570 1,394 $0.00
1036F 895 783 $0.00
1126F 717 647 $0.00
99000 750 729 $0.00
1125F 737 660 $0.00
3079F 415 386 $0.00
1034F 268 241 $0.00
90834 Psychotherapy, 45 minutes with patient 412 294 $0.00
3075F 50 40 $0.00
G0008 Administration of influenza virus vaccine 32 31 $0.00
36415 Collection of venous blood by venipuncture 14 13 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 55 55 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 28 26 $0.00
90656 19 18 $0.00