PRIMARY CARE OF THE BLUEGRASS, LLC

NPI 1942463096, organization, Crab Orchard, KY, Clinic/Center, Primary Care

Evidence tier

documented action, then payment

Listed on the KY Medicaid exclusion list since April 20, 2021.
Medicaid still paid claims in 34 later months, $20,782 in total.

score 94 of 100, rank 240, $21K at stake

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

list	identity check	action date	window closed	months paid after	first	last	paid after	12 months before
KY Medicaid exclusion list state list extracted from https://chfs.ky.gov/agencies/dms/dpi/pe/documents/kymedicaidterminationlist.xlsx (pandas claude colmap)	Exact NPI, name verified	Apr 20, 2021	still open	34	May 2021	May 2024	$21K	$21K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	PRIMARY CARE OF THE BLUEGRASS, LLC (also CRAB ORCHARD PRIMARY CARE)
Type	Organization
Status	Active
NPI issued	July 9, 2008, last updated September 2, 2021
Practice location	29 MAIN ST, Crab Orchard, KY 40419-6548, 606-355-7800
Mailing address	1031 WELLINGTON WAY STE 240, Lexington, KY 40513-1257
Authorized official	BRITTANY UNDERWOOD (Credentialing Agent)
Specialties	Clinic/Center, Rural Health (261QR1300X, license 900266 KY) Nurse Practitioner (363L00000X) Clinic/Center, Primary Care (261QP2300X, primary, license 700193 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.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$82K	91%	$31	$44 (top 5% from $110)	too few months to rank
90832	Psychotherapy, 30 minutes	$7K	8%	$37	$59 (top 5% from $239)	too few months to rank
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$2K	2%	$39	$60 (top 5% from $133)	too few months to rank
3008F	Medicaid service code	$0	0%	$0.00	$0.00 (top 5% from $1.17)	too few months to rank
1126F	Medicaid service code	$0	0%	$0.00	$0.00 (top 5% from $0.15)	too few months to rank

In this area

260 providers in KY carry an indicator in the public record, with $434.8M at stake between them. The most common is more hours than a day holds, on 185 of them, followed by part of a provider network on 43. 23 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	EDGEWATER RECOVERY CENTER LLC Morehead, KY, ranked 38	$6.5M	Listed on an HHS-OIG enforcement record since January 30, 2024. Medicaid still paid claims in 11 later months, $6,465,610 in total. and 1 more
1	RECOVERY CENTER OF KENTUCKY, LLC Elizabethtown, KY, ranked 41	$4.5M	Adjudicated (civil judgment) per a Department of Justice release dated May 15, 2026. Medicaid paid $4,466,448 in the last 12 observed months.
1	PIONEER HEALTH GROUP LLC Louisa, KY, ranked 47	$2.9M	Adjudicated (civil judgment) per an HHS-OIG enforcement record dated July 27, 2026. Medicaid paid $2,921,665 in the last 12 observed months.
1	MAJA CUPAC Louisville, KY, ranked 65	$9K	Listed on the KY Medicaid exclusion list since April 22, 2022. Medicaid still paid claims in 4 later months, $8,911 in total. and 1 more
1	MADISON PRIMARY CARE, LLC Richmond, KY, ranked 76	$612K	Listed on the KY Medicaid exclusion list since April 20, 2021. Medicaid still paid claims in 40 later months, $612,164 in total.
1	THOMAS HUGHES Bowling Green, KY, ranked 121	$152K	Listed on the IN Medicaid exclusion list since November 30, 2016. Medicaid still paid claims in 42 later months, $151,689 in total.
1	BAKER CHIROPRACTIC CENTER PSC Louisville, KY, ranked 139	$119K	Listed on the KY Medicaid exclusion list and the Medicare revocation list since January 4, 2024. Medicaid still paid claims in 10 later months, $119,249 in total.
1	MICHAEL BAKER Louisville, KY, ranked 140	$119K	Listed on the Medicare revocation list and the KY Medicaid exclusion list since January 4, 2024. Medicaid still paid claims in 10 later months, $119,249 in total.

All 260 in KY

Recent enforcement in KY

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedAug 27, 2026

Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges

Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.

DOJChargedJun 23, 2026

5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown

Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.

DOJCivil settlementJun 23, 2026

Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown

Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.

DOJCivil judgmentMay 15, 2026

Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations

The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.

DOJSentencedApr 24, 2026

Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud

Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.

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.

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