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CUMBERLAND FAMILY MEDICAL CENTER INC

Clinic/Center, Federally Qualified Health Center (FQHC)·BURKESVILLE, KY·NPI: 1306873500Share

Compared to Clinic/Center, Federally Qualified Health Center (FQHC) Peers

Total spending distribution among 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $72.5M is at the below 25th percentile among 16 Clinic/Center, Federally Qualified Health Center (FQHC) providers.

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

Total Paid

$72.5M

$72,464,216

Total Claims

2.7M

Beneficiaries

2.2M

1.2 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018
$6.7M
+20%
2019
$8.1M
-0%
2020
$8.1M
+28%
2021
$10.3M
+22%
2022
$12.5M
+16%
2023
$14.5M
-15%
2024
$12.3M

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 41% of total spending.

99213Normal range

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

$29.6M

891K claims · 40.8%

Your Cost: $33.23/claim|Median: $37.81
0.9× median
90832Normal range

Psychotherapy, 30 minutes

$5.7M

139K claims · 7.8%

Your Cost: $40.87/claim|Median: $41.28
1.0× median
99211Normal range

Office/outpatient visit, minimal complexity

$5.0M

379K claims · 7.0%

Your Cost: $13.31/claim|Median: $12.93
1.0× median
T2023Normal range

Community transition, waiver; per service

$3.0M

9,465 claims · 4.2%

Your Cost: $320.93/claim|Median: $300.13
1.1× median
87428Normal range

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

$2.6M

64K claims · 3.5%

Your Cost: $39.75/claim|Median: $39.63
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$2.1M

84K claims · 2.9%

Your Cost: $24.89/claim|Median: $25.06
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.9M

30K claims · 2.6%

Your Cost: $63.51/claim|Median: $75.18
0.8× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.8M

33K claims · 2.5%

Your Cost: $54.87/claim|Median: $69.35
0.8× median
99393Normal range

Preventive medicine, established patient, age 5-11

$1.7M

28K claims · 2.3%

Your Cost: $59.35/claim|Median: $74.82
0.8× median
90834Normal range

Psychotherapy, 45 minutes

$1.4M

26K claims · 1.9%

Your Cost: $53.19/claim|Median: $63.65
0.8× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$1.3M

102K claims · 1.8%

Your Cost: $12.93/claim|Median: $11.48
1.1× median
90837Normal range

Psychotherapy, 60 minutes

$1.2M

16K claims · 1.7%

Your Cost: $76.55/claim|Median: $85.66
0.9× median
99214Normal range

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

$1.1M

22K claims · 1.5%

Your Cost: $51.04/claim|Median: $53.41
1.0× median
G0467Normal range

Federally qualified health center visit, mental health

$1.0M

106K claims · 1.4%

Your Cost: $9.63/claim|Median: $21.91
0.4× median
D1120Top 25%

Prophylaxis, adult

$921K

23K claims · 1.3%

Your Cost: $40.76/claim|Median: $33.86
1.2× median
99394Normal range

Preventive medicine, established patient, age 12-17

$835K

12K claims · 1.2%

Your Cost: $66.86/claim|Median: $80.15
0.8× median
87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$808K

22K claims · 1.1%

Your Cost: $36.58/claim|Median: $30.53
1.2× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$579K

45K claims · 0.8%

Your Cost: $12.74/claim|Median: $17.85
0.7× median
87426Normal range

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

$574K

28K claims · 0.8%

Your Cost: $20.55/claim|Median: $30.04
0.7× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$570K

44K claims · 0.8%

Your Cost: $12.92/claim|Median: $9.80
1.3× median
87804Normal range

Influenza virus detection, rapid test

$550K

43K claims · 0.8%

Your Cost: $12.90/claim|Median: $12.59
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$548K

17K claims · 0.8%

Your Cost: $31.88/claim|Median: $32.07
1.0× median
90686Top 25%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$478K

30K claims · 0.7%

Your Cost: $16.05/claim|Median: $7.18
2.2× median
99203Normal range

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

$459K

9,678 claims · 0.6%

Your Cost: $47.46/claim|Median: $57.85
0.8× median
J0696Top 5%

$377K

14K claims · 0.5%

Your Cost: $26.21/claim|Median: $1.34
19.6× median
D0120Normal range

Periodic oral evaluation, established patient

$355K

16K claims · 0.5%

Your Cost: $22.14/claim|Median: $24.34
0.9× median
D1206Normal range

Topical application of fluoride varnish

$320K

25K claims · 0.4%

Your Cost: $12.65/claim|Median: $18.12
0.7× median
90887Normal range

Interpretation/explanation of results

$311K

6,675 claims · 0.4%

Your Cost: $46.63/claim|Median: $47.55
1.0× median
99395Normal range

Preventive medicine, established patient, age 18-39

$308K

4,739 claims · 0.4%

Your Cost: $64.91/claim|Median: $72.71
0.9× median
90791Normal range

Psychiatric diagnostic evaluation

$305K

3,684 claims · 0.4%

Your Cost: $82.89/claim|Median: $99.21
0.8× median
D1110Normal range

Prophylaxis, adult cleaning

$300K

6,766 claims · 0.4%

Your Cost: $44.33/claim|Median: $43.38
1.0× median
59025Normal range

Fetal non-stress test

$241K

9,146 claims · 0.3%

Your Cost: $26.40/claim|Median: $26.45
1.0× median
76815Normal range

Ultrasound, pregnant uterus, limited

$237K

5,643 claims · 0.3%

Your Cost: $41.91/claim|Median: $36.79
1.1× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$202K

5,148 claims · 0.3%

Your Cost: $39.20/claim|Median: $40.11
1.0× median
J1050Top 25%

Injection, medroxyprogesterone acetate, one milligram

$185K

2,568 claims · 0.3%

Your Cost: $71.85/claim|Median: $41.92
1.7× median
59409Normal range

Vaginal delivery only

$178K

247 claims · 0.2%

Your Cost: $720.60/claim|Median: $619.91
1.2× median
D0140Top 5%

Limited oral evaluation, problem focused

$152K

1,814 claims · 0.2%

Your Cost: $83.57/claim|Median: $27.07
3.1× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$149K

2,940 claims · 0.2%

Your Cost: $50.55/claim|Median: $37.22
1.4× median
99218Normal range

$139K

3,402 claims · 0.2%

Your Cost: $40.98/claim|Median: $51.50
0.8× median
85025Normal range

Complete blood count (CBC) with differential, automated

$130K

19K claims · 0.2%

Your Cost: $6.86/claim|Median: $4.71
1.5× median
80305Normal range

$129K

13K claims · 0.2%

Your Cost: $9.77/claim|Median: $7.44
1.3× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$111K

1,968 claims · 0.2%

Your Cost: $56.40/claim|Median: $58.55
1.0× median
D0274Normal range

Bitewings, four radiographic images

$106K

4,058 claims · 0.1%

Your Cost: $26.21/claim|Median: $22.54
1.2× median
87807Normal range

$106K

9,291 claims · 0.1%

Your Cost: $11.37/claim|Median: $10.06
1.1× median
76830Normal range

Ultrasound, transvaginal

$105K

1,937 claims · 0.1%

Your Cost: $54.35/claim|Median: $57.47
0.9× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$90K

1,247 claims · 0.1%

Your Cost: $72.03/claim|Median: $74.78
1.0× median
99174Top 25%

$90K

6,854 claims · 0.1%

Your Cost: $13.09/claim|Median: $5.27
2.5× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$88K

1,952 claims · 0.1%

Your Cost: $45.10/claim|Median: $47.65
0.9× median
59410Normal range

$86K

133 claims · 0.1%

Your Cost: $649.24/claim|Median: $781.64
0.8× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$82K

1,260 claims · 0.1%

Your Cost: $65.30/claim|Median: $71.00
0.9× median

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