LAURIE KAY BALLEW, D.O.
NPI 1639141948, individual, Paducah, KY, Psychiatry & Neurology, Psychiatry
- Hours beyond a day in 7 months, but with up to 1278 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code G0482 ($256 per patient-month) sit in the top 5% of every provider billing that code.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 26.9 | 30.2 | 20.1 | 27.5 | 1001 | 2 | 90833 90834 90837 99204 99213 99214 | $71K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 26.0 | 29.9 | 20.0 | 29.5 | 1034 | 2 | 90833 90834 90837 99204 99213 99214 99354 | $72K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 34.7 | 38.2 | 25.5 | 34.3 | 1154 | 2 | 90833 90837 96112 96113 99204 99213 99214 99354 | $92K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 32.7 | 38.1 | 25.4 | 34.7 | 1183 | 2 | 90832 90833 90837 99204 99213 99214 99354 | $89K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 31.2 | 36.4 | 24.2 | 35.8 | 1167 | 2 | 90832 90833 90837 96112 96113 99204 99213 99214 99354 | $87K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 29.3 | 34.6 | 23.1 | 31.5 | 1120 | 2 | 90832 90833 90837 99204 99213 99214 | $81K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 24.8 | 31.1 | 20.8 | 29.3 | 980 | 1 | 90833 90837 96112 96113 99204 99213 99214 | $75K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | LAURIE KAY BALLEW, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | February 2, 2006, last updated September 20, 2024 |
| Practice location | 2520 NEW HOLT RD STE I, Paducah, KY 42001-7547, 270-558-3916 |
| Mailing address | PO BOX 636961, Cincinnati, OH 45263-6961 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 02436 KY) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $788K | 15% | $74 | $60 (top 5% from $133) | 65th percentile | |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $726K | 14% | $256 | $133 (top 5% from $245) | 96th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $656K | 13% | $66 | $45 (top 5% from $110) | 77th percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $598K | 12% | $47 | $49 (top 5% from $109) | 47th percentile | |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $512K | 10% | $175 | $146 (top 5% from $318) | 66th percentile | |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $447K | 9% | $107 | $98 (top 5% from $199) | 56th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $409K | 8% | $50 | $44 (top 5% from $110) | 59th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $277K | 5% | $137 | $191 (top 5% from $442) | 25th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 90868 | Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management | 442 | 13 | $60K | $350 | $174 | 2.0x | 3.4x (90th percentile 10.3x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 622 | 185 | $52K | $154 | $112 | 1.4x | 2.3x (90th percentile 3.8x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 623 | 193 | $31K | $104 | $65 | 1.6x | 2.1x (90th percentile 3.5x) |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 102 | 17 | $15K | $300 | $143 | 2.1x | 3.1x (90th percentile 6.1x) |
| 80307 | Testing for presence of drug, by chemistry analyzers | 186 | 44 | $11K | $120 | $59 | 2.0x | 3.2x (90th percentile 7.6x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 189 | 53 | $10K | $106 | $77 | 1.4x | 2.2x (90th percentile 3.8x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 53 | 53 | $6K | $231 | $146 | 1.6x | 2.4x (90th percentile 3.9x) |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 29 | 19 | $3K | $243 | $112 | 2.2x | 2.7x (90th percentile 6.1x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
7 providers in McCracken County, KY carry an indicator in the public record, with $6.9M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | BAPTIST HEALTH HOME CARE KY LLC Paducah, KY, ranked 2409 | $0 |
|
| 3 | PROVIDENCE POINT HEALTHCARE, INC. Paducah, KY, ranked 5958 | $0 |
|
| 4 | SHELLY BAER Paducah, KY, ranked 8478 | $3.8M |
|
| 4 | GRETCHEN ROOF Paducah, KY, ranked 8664 | $2.3M |
|
| 4 | SAMANTHA JONES Paducah, KY, ranked 9288 | $387K |
|
| 4 | DEREK RATLIFF Paducah, KY, ranked 9317 | $349K |
|
| 5 | DANIEL SUSSMAN Paducah, KY, ranked 11593 | $124K |
Recent enforcement in KY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.