Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

MOUNTAINEER FAMILY MEDICINE, INC.

Family Medicine·CHARLESTON, WV·NPI: 1295874436Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $19.5M is at the 75th percentile among 19 Family Medicine providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$19.5M

$19,541,017

Total Claims

495K

Beneficiaries

250K

2.0 claims/patient

Avg Cost/Claim

$39

Monthly Spending Trend

Yearly Spending

2018
$3.3M
-57%
2019
$1.4M
+208%
2020
$4.4M
-15%
2021
$3.7M
-33%
2022
$2.5M
-9%
2023
$2.2M
-4%
2024
$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 27% of total spending.

99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$5.3M

111K claims · 26.9%

Your Cost: $47.40/claim|Median: $37.81
1.3× median
80307Top 25%

Drug test, presumptive, by chemistry analyzers

$3.0M

53K claims · 15.3%

Your Cost: $56.93/claim|Median: $35.43
1.6× median
G0482Normal range

Drug test, definitive, 15-21 drug classes

$2.7M

31K claims · 13.8%

Your Cost: $87.42/claim|Median: $75.26
1.2× median
90832Normal range

Psychotherapy, 30 minutes

$1.2M

31K claims · 6.3%

Your Cost: $39.39/claim|Median: $41.28
1.0× median
G0480Normal range

Drug test, definitive, 1-7 drug classes

$1.2M

26K claims · 6.2%

Your Cost: $46.49/claim|Median: $37.56
1.2× median
82075Top 25%

Alcohol (ethanol) breath test

$1.2M

51K claims · 6.0%

Your Cost: $23.02/claim|Median: $16.59
1.4× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$874K

12K claims · 4.5%

Your Cost: $73.11/claim|Median: $53.41
1.4× median
90837Normal range

Psychotherapy, 60 minutes

$677K

7,537 claims · 3.5%

Your Cost: $89.87/claim|Median: $85.66
1.0× median
G0483Top 5%

Drug test, definitive, 22+ drug classes

$435K

1,770 claims · 2.2%

Your Cost: $245.52/claim|Median: $90.89
2.7× median
99212Normal range

Office/outpatient visit, low complexity

$433K

14K claims · 2.2%

Your Cost: $29.93/claim|Median: $25.06
1.2× median
G0481Normal range

Drug test, definitive, 8-14 drug classes

$421K

5,627 claims · 2.2%

Your Cost: $74.85/claim|Median: $64.72
1.2× median
80305Normal range

$276K

37K claims · 1.4%

Your Cost: $7.53/claim|Median: $7.44
1.0× median
99407Normal range

$208K

21K claims · 1.1%

Your Cost: $9.80/claim|Median: $13.29
0.7× median
90853Normal range

Group psychotherapy

$190K

6,056 claims · 1.0%

Your Cost: $31.33/claim|Median: $25.02
1.3× median
99401Top 10%

$157K

4,704 claims · 0.8%

Your Cost: $33.28/claim|Median: $16.53
2.0× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$125K

2,917 claims · 0.6%

Your Cost: $42.95/claim|Median: $57.85
0.7× median
90834Normal range

Psychotherapy, 45 minutes

$122K

2,324 claims · 0.6%

Your Cost: $52.53/claim|Median: $63.65
0.8× median
99406Top 5%

$121K

4,665 claims · 0.6%

Your Cost: $25.99/claim|Median: $6.53
4.0× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$121K

1,725 claims · 0.6%

Your Cost: $70.02/claim|Median: $111.09
0.6× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$102K

3,346 claims · 0.5%

Your Cost: $30.60/claim|Median: $30.04
1.0× median
99408Normal range

$92K

17K claims · 0.5%

Your Cost: $5.52/claim|Median: $9.32
0.6× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$77K

1,186 claims · 0.4%

Your Cost: $65.17/claim|Median: $84.03
0.8× median
99385Normal range

Preventive visit, new patient, 18-39 yr

$68K

1,649 claims · 0.3%

Your Cost: $40.97/claim|Median: $76.22
0.5× median
90791Normal range

Psychiatric diagnostic evaluation

$61K

1,100 claims · 0.3%

Your Cost: $55.61/claim|Median: $99.21
0.6× median
Q3014Normal range

Telehealth originating site facility fee

$61K

4,217 claims · 0.3%

Your Cost: $14.44/claim|Median: $15.37
0.9× median
99386Normal range

Preventive visit, new patient, 40-64 yr

$58K

1,444 claims · 0.3%

Your Cost: $40.21/claim|Median: $87.82
0.5× median
81025Top 5%

Urine pregnancy test

$54K

2,152 claims · 0.3%

Your Cost: $25.30/claim|Median: $4.81
5.3× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$46K

6,733 claims · 0.2%

Your Cost: $6.89/claim|Median: $9.56
0.7× median
99396Normal range

Preventive medicine, established patient, age 40-64

$38K

432 claims · 0.2%

Your Cost: $88.09/claim|Median: $76.06
1.2× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$32K

337 claims · 0.2%

Your Cost: $95.40/claim|Median: $72.71
1.3× median
87633Normal range

Respiratory virus detection, 12-25 targets, nucleic acid

$18K

296 claims · 0.1%

Your Cost: $60.83/claim|Median: $169.17
0.4× median
H0031Normal range

Mental health assessment by non-physician

$13K

267 claims · 0.1%

Your Cost: $47.36/claim|Median: $96.18
0.5× median
90847Normal range

Family psychotherapy with patient, 50 min

$12K

409 claims · 0.1%

Your Cost: $28.67/claim|Median: $77.33
0.4× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$11K

1,598 claims · 0.1%

Your Cost: $6.71/claim|Median: $9.70
0.7× median
76942Top 1%

$9K

40 claims · 0.0%

Your Cost: $213.42/claim|Median: $24.73
8.6× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$8K

3,632 claims · 0.0%

Your Cost: $2.24/claim|Median: $3.67
0.6× median
99215Normal range

Office/outpatient visit, high complexity

$7K

84 claims · 0.0%

Your Cost: $87.73/claim|Median: $74.09
1.2× median
J3420Normal range

Injection, vitamin B-12 cyanocobalamin, up to one thousand mcg

$7K

5,568 claims · 0.0%

Your Cost: $1.26/claim|Median: $1.04
1.2× median
80306Normal range

$7K

2,048 claims · 0.0%

Your Cost: $3.39/claim|Median: $10.29
0.3× median
86328Normal range

$6K

298 claims · 0.0%

Your Cost: $21.10/claim|Median: $20.52
1.0× median
G0108Normal range

Diabetes self-management training, individual

$6K

383 claims · 0.0%

Your Cost: $16.27/claim|Median: $35.89
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$3K

112 claims · 0.0%

Your Cost: $27.81/claim|Median: $40.11
0.7× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$3K

5,896 claims · 0.0%

Your Cost: $0.50/claim|Median: $22.44
0.0× median
G0444Normal range

Annual depression screening, fifteen minutes

$2K

2,497 claims · 0.0%

Your Cost: $0.89/claim|Median: $4.23
0.2× median
99345Normal range

$2K

62 claims · 0.0%

Your Cost: $33.68/claim|Median: $56.78
0.6× median
G0396Normal range

Alcohol/substance abuse structured assessment, 15-30 minutes

$2K

477 claims · 0.0%

Your Cost: $4.14/claim|Median: $40.58
0.1× median
99348Normal range

$1K

101 claims · 0.0%

Your Cost: $13.84/claim|Median: $17.17
0.8× median
36415Normal range

Collection of venous blood by venipuncture

$1K

1,066 claims · 0.0%

Your Cost: $0.98/claim|Median: $1.57
0.6× median
99347Normal range

$706

129 claims · 0.0%

Your Cost: $5.47/claim|Median: $11.74
0.5× median
87804Normal range

Influenza virus detection, rapid test

$629

51 claims · 0.0%

Your Cost: $12.33/claim|Median: $12.59
1.0× median

Other Top Providers in West Virginia

View all →

Rem Community Options Inc.

Community/Behavioral Health

$224.9M

Laboratory Corporation of America Holdings

Clinical Medical Laboratory

$220.0M

Charleston Area Medical Center INC

General Acute Care Hospital

$199.8M

Voca Corporation of West Virginia Inc.

Clinic/Center Developmental Disabilities

$178.3M

Mulberry Street Management Services Inc.

In Home Supportive Care

$175.6M

Similar Providers

Other top providers in Family Medicine

Dap Health, Inc.

El Cajon, CA

$270.2M

Adelante Healthcare, Inc.

Phoenix, AZ

$245.9M

Fast Pace Medical Clinic PLLC

Spring Hill, TN

$179.4M

← All providersAll providers in West Virginia →How we detect fraud →