East Mountain Health Physicians, INC.
East Mountain Health Physicians, INC. was paid $471K by Medicaid between Jan 2018 and Dec 2024, across 17 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 58% of everything it billed.
MARTINSBURG, WV 25401
Next to other Clinical Social Worker providers in West Virginia
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 | |
|---|---|---|---|
| 2018 | 219 | $12K | |
| 2019 | 694 | $35K | |
| 2020 | 1,447 | $73K | |
| 2021 | 2,852 | $76K | |
| 2022 | 3,129 | $101K | |
| 2023 | 3,509 | $97K | |
| 2024incomplete | 1,718 | $77K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 58% | 4,270 | 3,887 | $275K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 31% | 2,912 | 2,645 | $146K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 8.1% | 459 | 435 | $38K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.2% | 72 | 67 | $5K |
| 36415 | Collection of venous blood by venipuncture | <1% | 116 | 111 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 23 | 21 | $1K |
| 99000 | <1% | 91 | 84 | $1K | |
| 90686 | <1% | 23 | 22 | $1K | |
| 82962 | <1% | 96 | 92 | $542.35 | |
| 99406 | <1% | 37 | 37 | $292.65 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 14 | 13 | $98.31 |
| 3078F | <1% | 1,901 | 1,683 | $25.00 |
5 more codes
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
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.