Clinic
Big Sandy Health Care INC
Big Sandy Health Care INC was paid $1.01M by Medicaid between Aug 2018 and Dec 2024, across 39 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
33Billing provider infoBIG SANDY HEALTH CARE INC
SALYERSVILLE, KY 41465
SALYERSVILLE, KY 41465
33aNPI1922594506assigned 07/06/2018
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$1.01M
24GClaims29,722
24DCodes billed39
24AFirst – last monthAug 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Kentucky
Rank by total paid#20 of 37
Median peer was paid$1.29M
This provider vs. median0.8×
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.
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 | 16 | $275.74 | |
| 2019 | 60 | $2K | |
| 2020 | 1,317 | $40K | |
| 2021 | 5,257 | $141K | |
| 2022 | 6,534 | $162K | |
| 2023 | 7,981 | $221K | |
| 2024incomplete | 8,557 | $449K |
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 | 46% | 13,319 | 11,201 | $470K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 27% | 856 | 813 | $271K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.5% | 701 | 609 | $46K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.6% | 1,121 | 1,062 | $36K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 3.4% | 1,033 | 975 | $34K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.4% | 3,202 | 1,663 | $34K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.8% | 2,752 | 2,578 | $29K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.5% | 369 | 366 | $26K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.2% | 1,497 | 1,453 | $12K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.1% | 178 | 175 | $11K |
| 90461 | <1% | 921 | 892 | $10K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 357 | 353 | $9K |
27 more codes
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 85 | $5K |
| 87420 | <1% | 506 | $4K | |
| 99173 | <1% | 128 | $3K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 58 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 41 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 119 | $3K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 206 | $2K |
| 99460 | <1% | 40 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 14 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 25 | $416.30 |
| 94010 | <1% | 16 | $275.74 | |
| 92558 | <1% | 41 | $266.16 | |
| 80061 | Lipid panel | <1% | 24 | $183.16 |
| 36415 | Collection of venous blood by venipuncture | <1% | 13 | $67.60 |
| 90686 | <1% | 82 | $58.30 | |
| 36416 | <1% | 86 | $39.24 | |
| 87070 | <1% | 17 | $6.47 | |
| 90677 | <1% | 33 | $0.10 | |
| 90670 | <1% | 103 | $0.05 | |
| 90648 | <1% | 51 | $0.05 | |
| 90680 | <1% | 41 | $0.04 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 302 | $0.01 |
| 90723 | 0% | 12 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 1,151 | $0.00 |
| A4617 | Mouth piece | 0% | 135 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 70 | $0.00 |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | 0% | 17 | $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 officialHERALD, JAMES (CEO)
Parent organizationBIG SANDY HEALTH CARE INC
| Provider | Location | Paid |
|---|---|---|
| Big Sandy Health Care INC | Auxier, KY | $4.57M |
| Big Sandy Health Care, INC | Inez, KY | $2.30M |
| Big Sandy Health Care INC | Salyersville, KY | $1.99M |
| Big Sandy Health Care INC | Grethel, KY | $1.74M |
| Big Sandy Health Care INC | Pikeville, KY | $1.73M |
| Big Sandy Health Care INC | Pikeville, KY | $530K |
| Big Sandy Health Care INC | Harold, KY | $416K |
| The Pathology Group PC | Memphis, TN | $380K |
| Big Sandy Health Care INC | Freeburn, KY | $114K |
| Big Sandy Health Care INC | Paintsville, KY | $48K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.