Pinelake Physician Practice LLC
Pinelake Physician Practice LLC was paid $1.01M by Medicaid between Aug 2021 and Dec 2024, across 54 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 55% of everything it billed.
MAYFIELD, KY 42066
Next to other Rural Health Clinic/Center providers in Kentucky
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2021 | 1,169 | $25K | |
| 2022 | 19,457 | $307K | |
| 2023 | 43,594 | $366K | |
| 2024incomplete | 24,790 | $309K |
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 | 55% | 16,614 | 14,400 | $555K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 2,470 | 2,352 | $107K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.9% | 1,335 | 1,262 | $89K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.3% | 1,230 | 1,155 | $74K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 5.8% | 4,098 | 3,780 | $59K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.5% | 534 | 475 | $35K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.4% | 179 | 156 | $14K |
| 90461 | 1.3% | 446 | 425 | $13K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.3% | 981 | 804 | $13K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 423 | 380 | $12K |
| 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% | 188 | 159 | $8K |
| 87400 | <1% | 675 | 232 | $5K |
42 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 82 | $5K |
| 87428 | <1% | 140 | $5K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 315 | $4K |
| 90670 | <1% | 316 | $2K | |
| 87430 | <1% | 114 | $2K | |
| 90697 | <1% | 500 | $1K | |
| 83655 | <1% | 94 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 57 | $690.52 |
| 85018 | <1% | 301 | $613.39 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 55 | $371.35 |
| 90680 | <1% | 447 | $306.82 | |
| 90671 | <1% | 511 | $270.86 | |
| 87807 | <1% | 17 | $222.70 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 15 | $129.80 |
| 90716 | <1% | 24 | $123.00 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 36 | $70.65 |
| 90686 | <1% | 66 | $65.53 | |
| 90710 | <1% | 32 | $39.00 | |
| 90715 | <1% | 63 | $37.42 | |
| 90633 | <1% | 228 | $31.03 | |
| 81002 | <1% | 28 | $20.96 | |
| 90696 | <1% | 30 | $13.04 | |
| 3078F | <1% | 7,974 | $6.74 | |
| 3074F | <1% | 8,053 | $6.37 | |
| 3008F | <1% | 13,250 | $4.32 | |
| 1160F | <1% | 11,611 | $4.26 | |
| 1159F | <1% | 11,613 | $4.26 | |
| J7611 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg | <1% | 14 | $2.96 |
| 3079F | <1% | 392 | $1.22 | |
| 3075F | <1% | 236 | $0.77 | |
| 1036F | <1% | 2,165 | $0.43 | |
| 1034F | <1% | 333 | $0.10 | |
| 90700 | 0% | 28 | $0.00 | |
| 3725F | 0% | 338 | $0.00 | |
| 90734 | 0% | 49 | $0.00 | |
| 90723 | 0% | 79 | $0.00 | |
| 1035F | 0% | 17 | $0.00 | |
| 90619 | 0% | 59 | $0.00 | |
| 90647 | 0% | 90 | $0.00 | |
| 99000 | 0% | 31 | $0.00 | |
| 90651 | 0% | 16 | $0.00 | |
| 36416 | 0% | 18 | $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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Rchp-Wilmington, LLC | Wilmington, OH | $13.53M |
| Providence Hospital, LLC | Columbia, SC | $12.68M |
| Vaughan Regional Medical Center LLC | Selma, AL | $8.15M |
| Kershaw Hospital LLC | Camden, SC | $7.93M |
| Bolivar Physician Practices LLC | Cleveland, MS | $3.05M |
| Wilmington Physicians Group LLC | Wilmington, OH | $3.04M |
| Phc-Morgan City LP | Morgan City, LA | $2.37M |
| Community Hospital of Andalusia LLC | Andalusia, AL | $2.27M |
| Vaughan Regional Medical Center LLC | Marion, AL | $2.15M |
| PRHC Ennis LP | Ennis, TX | $1.81M |
| Andalusia Physician Practices LLC | Andalusia, AL | $847K |
| Meadowview Physician Practice LLC | Maysville, KY | $783K |
| Logan Physician Practice LLC | Russellville, KY | $317K |
| Kentucky Mso LLC | Georgetown, KY | $248K |
| Rchp-Wilmington, LLC | Wilmington, OH | $165K |
| Meadowview Physician Practice LLC | Maysville, KY | $140K |
| Amg-Southern Tennessee LLC | Monteagle, TN | $136K |
| Lake Cumberland Physician Practices LLC | Somerset, KY | $135K |
| Lake Cumberland Physician Practices LLC | Somerset, KY | $57K |
| Kershaw Hospital LLC | Lugoff, SC | $49K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.