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PIKEVILLE MEDICAL CENTER INC.

Clinic/Center, Multi-Specialty·PIKEVILLE, KY·NPI: 1528195864Share

Compared to Clinic/Center, Multi-Specialty Peers

Total spending distribution among 12 providers in this specialty

P25MedianP75P90

This provider's total spending of $34.4M is at the 25th percentile among 12 Clinic/Center, Multi-Specialty providers.

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

Total Paid

$34.4M

$34,419,459

Total Claims

1.0M

Beneficiaries

835K

1.2 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$5.4M
-7%
2019
$5.0M
-8%
2020
$4.6M
-0%
2021
$4.6M
-1%
2022
$4.6M
+22%
2023
$5.6M
-16%
2024
$4.7M

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 22% of total spending.

99213Normal range

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

$7.6M

278K claims · 22.2%

Your Cost: $27.45/claim|Median: $37.81
0.7× median
99284Normal range

Emergency dept visit, high complexity

$4.3M

75K claims · 12.4%

Your Cost: $56.72/claim|Median: $69.51
0.8× median
99214Normal range

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

$2.8M

70K claims · 8.2%

Your Cost: $40.13/claim|Median: $53.41
0.8× median
99291Normal range

Critical care, first 30-74 minutes

$2.2M

26K claims · 6.3%

Your Cost: $84.70/claim|Median: $101.24
0.8× median
99203Normal range

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

$1.8M

40K claims · 5.1%

Your Cost: $43.38/claim|Median: $57.85
0.7× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$1.6M

72K claims · 4.6%

Your Cost: $22.19/claim|Median: $23.99
0.9× median
99283Normal range

Emergency dept visit, moderate complexity

$1.4M

39K claims · 4.1%

Your Cost: $35.76/claim|Median: $42.48
0.8× median
99285Normal range

Emergency dept visit, high/urgent complexity

$1.3M

17K claims · 3.8%

Your Cost: $79.04/claim|Median: $85.65
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$910K

55K claims · 2.6%

Your Cost: $16.43/claim|Median: $25.06
0.7× median
99204Normal range

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

$815K

11K claims · 2.4%

Your Cost: $72.04/claim|Median: $84.03
0.9× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$651K

18K claims · 1.9%

Your Cost: $35.37/claim|Median: $54.68
0.6× median
93010Normal range

Electrocardiogram, interpretation and report only

$612K

97K claims · 1.8%

Your Cost: $6.31/claim|Median: $5.60
1.1× median
43239Normal range

Upper GI endoscopy with biopsy

$519K

5,492 claims · 1.5%

Your Cost: $94.53/claim|Median: $151.68
0.6× median
97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$439K

2,769 claims · 1.3%

Your Cost: $158.65/claim|Median: $167.38
0.9× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$406K

10K claims · 1.2%

Your Cost: $40.03/claim|Median: $43.85
0.9× median
99222Normal range

Initial hospital care, per day, moderate complexity

$401K

7,999 claims · 1.2%

Your Cost: $50.19/claim|Median: $51.25
1.0× median
59410Normal range

$384K

523 claims · 1.1%

Your Cost: $733.69/claim|Median: $781.64
0.9× median
20610Normal range

Arthrocentesis, aspiration/injection, major joint

$371K

10K claims · 1.1%

Your Cost: $36.21/claim|Median: $29.03
1.2× median
99233Normal range

Subsequent hospital care, per day, high complexity

$352K

11K claims · 1.0%

Your Cost: $32.47/claim|Median: $35.30
0.9× median
96110Top 10%

Developmental screening, per standardized instrument

$334K

10K claims · 1.0%

Your Cost: $33.28/claim|Median: $9.10
3.7× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$319K

5,934 claims · 0.9%

Your Cost: $53.73/claim|Median: $69.35
0.8× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$236K

8,734 claims · 0.7%

Your Cost: $27.02/claim|Median: $58.55
0.5× median
99392Normal range

Preventive medicine, established patient, age 1-4

$220K

3,707 claims · 0.6%

Your Cost: $59.40/claim|Median: $75.18
0.8× median
11042Normal range

Debridement, subcutaneous tissue, first 20 sq cm

$182K

8,690 claims · 0.5%

Your Cost: $20.91/claim|Median: $36.13
0.6× median
42820Normal range

Tonsillectomy and adenoidectomy, under age 12

$175K

900 claims · 0.5%

Your Cost: $194.61/claim|Median: $331.68
0.6× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$149K

4,283 claims · 0.4%

Your Cost: $34.82/claim|Median: $37.22
0.9× median
69436Normal range

Tympanostomy, general anesthesia

$138K

893 claims · 0.4%

Your Cost: $154.08/claim|Median: $205.50
0.7× median
99243Normal range

Office or other outpatient consultation, low complexity

$126K

1,602 claims · 0.4%

Your Cost: $78.66/claim|Median: $82.43
1.0× median
00170Normal range

Anesthesia for intraoral procedures

$122K

1,756 claims · 0.4%

Your Cost: $69.51/claim|Median: $132.89
0.5× median
99480Normal range

Subsequent intensive care, very low birth weight infant

$115K

1,298 claims · 0.3%

Your Cost: $88.28/claim|Median: $98.15
0.9× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$113K

4,755 claims · 0.3%

Your Cost: $23.84/claim|Median: $47.65
0.5× median
59409Normal range

Vaginal delivery only

$112K

178 claims · 0.3%

Your Cost: $631.39/claim|Median: $619.91
1.0× median
29826Normal range

$92K

474 claims · 0.3%

Your Cost: $194.34/claim|Median: $185.18
1.0× median
99223Normal range

Initial hospital care, per day, high complexity

$91K

1,457 claims · 0.3%

Your Cost: $62.57/claim|Median: $67.32
0.9× median
99395Normal range

Preventive medicine, established patient, age 18-39

$87K

1,361 claims · 0.3%

Your Cost: $64.22/claim|Median: $72.71
0.9× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$86K

2,330 claims · 0.3%

Your Cost: $36.94/claim|Median: $74.78
0.5× median
99282Normal range

Emergency dept visit, low complexity

$84K

4,952 claims · 0.2%

Your Cost: $16.97/claim|Median: $37.72
0.4× median
93454Normal range

$84K

761 claims · 0.2%

Your Cost: $110.01/claim|Median: $141.82
0.8× median
59025Normal range

Fetal non-stress test

$83K

3,629 claims · 0.2%

Your Cost: $22.74/claim|Median: $26.45
0.9× median
78452Normal range

Myocardial perfusion imaging, SPECT, multiple studies

$81K

2,161 claims · 0.2%

Your Cost: $37.61/claim|Median: $106.14
0.4× median
99221Normal range

Initial hospital care, straightforward/low

$81K

2,991 claims · 0.2%

Your Cost: $27.12/claim|Median: $39.96
0.7× median
76830Normal range

Ultrasound, transvaginal

$72K

2,788 claims · 0.2%

Your Cost: $25.73/claim|Median: $57.47
0.4× median
88305Normal range

Surgical pathology, gross and microscopic examination

$71K

2,186 claims · 0.2%

Your Cost: $32.63/claim|Median: $35.80
0.9× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$70K

1,628 claims · 0.2%

Your Cost: $42.93/claim|Median: $62.48
0.7× median
45380Normal range

Colonoscopy with biopsy

$67K

433 claims · 0.2%

Your Cost: $154.22/claim|Median: $200.68
0.8× median
97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$65K

568 claims · 0.2%

Your Cost: $114.30/claim|Median: $146.45
0.8× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$63K

2,964 claims · 0.2%

Your Cost: $21.41/claim|Median: $40.11
0.5× median
99231Normal range

Subsequent hospital care, per day, low complexity

$63K

4,839 claims · 0.2%

Your Cost: $12.94/claim|Median: $16.77
0.8× median
90935Normal range

Hemodialysis, one evaluation

$61K

1,719 claims · 0.2%

Your Cost: $35.62/claim|Median: $23.72
1.5× median
71045Normal range

Chest X-ray, single view

$57K

11K claims · 0.2%

Your Cost: $5.16/claim|Median: $4.93
1.0× median

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