Clinic
Tri-State Community Health Center, INC
Tri-State Community Health Center, INC was paid $1.69M by Medicaid between Jan 2018 and Oct 2024, across 20 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 89% of everything it billed.
33Billing provider infoTRI-STATE COMMUNITY HEALTH CENTER, INC
BERKELEY SPRINGS, WV 25411
BERKELEY SPRINGS, WV 25411
33aNPI1083055081assigned 07/08/2013
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$1.69M
24GClaims35,527
24DCodes billed20
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
Rank by total paid#64 of 205
Median peer was paid$521K
This provider vs. median3.2×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 5,507 | $251K | |
| 2019 | 3,512 | $169K | |
| 2020 | 6,950 | $294K | |
| 2021 | 5,790 | $265K | |
| 2022 | 6,157 | $297K | |
| 2023 | 4,957 | $246K | |
| 2024incomplete | 2,654 | $166K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 89% | 14,126 | 11,506 | $1.50M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.5% | 7,058 | 6,103 | $75K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 3.3% | 6,007 | 5,195 | $56K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 2,694 | 2,471 | $24K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,003 | 953 | $11K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 260 | 255 | $6K |
| 96127 | <1% | 575 | 397 | $5K | |
| 81003 | <1% | 160 | 143 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,915 | 987 | $2K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 226 | 153 | $2K |
| 87428 | <1% | 469 | 437 | $1K | |
| 90688 | <1% | 29 | 29 | $1K |
8 more codes
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 230 | $20.00 |
| G0467 | Community health center visit, returning patient | <1% | 571 | $9.53 |
| 94760 | 0% | 96 | $0.00 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 15 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 24 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 15 | $0.00 |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 40 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 14 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialDESHONG, SHEILA (COO)
| Provider | Location | Paid |
|---|---|---|
| Tri-State Community Health Center, INC | Hancock, MD | $5.81M |
| Tri-State Community Health Center, INC | Mcconnellsburg, PA | $1.68M |
| Tri-State Community Health Center, INC | Cumberland, MD | $741K |
| Tri-State Community Health Center, INC | Cumberland, MD | $355K |
| Tri-State Community Health Center-Hosp Physicians Practice | Cumberland, MD | $89K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.