Clinic
Tri-County Pediatrics LLC
Tri-County Pediatrics LLC was paid $1.78M by Medicaid between Jan 2018 and Apr 2020, across 27 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 38% of everything it billed.
33Billing provider infoTRI-COUNTY PEDIATRICS LLC
YORK, SC 29745
YORK, SC 29745
33aNPI1114066883assigned 02/06/2007
33bProvider typeRural Health Clinic/Center
28Total paid$1.78M
24GClaims35,727
24DCodes billed27
24AFirst – last monthJan 2018 – Apr 2020
Compared with peers
Next to other Rural Health Clinic/Center providers in South Carolina
Rank by total paid#16 of 81
Median peer was paid$302K
This provider vs. median5.9×
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 | 12,966 | $694K | |
| 2019 | 17,698 | $841K | |
| 2020 | 5,063 | $247K |
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 | 38% | 8,189 | 6,762 | $680K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 31% | 8,126 | 6,932 | $548K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.4% | 1,189 | 1,164 | $96K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.4% | 1,199 | 1,128 | $96K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.8% | 1,045 | 1,023 | $85K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.3% | 703 | 682 | $58K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.0% | 2,194 | 1,867 | $54K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.2% | 2,858 | 2,724 | $39K |
| G9153 | Mapcp demonstration - physician incentive pool | 1.9% | 1,118 | 1,087 | $34K |
| 90461 | 1.5% | 1,266 | 1,255 | $28K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.4% | 2,028 | 2,011 | $25K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,791 | 1,721 | $13K |
15 more codes
| 99188 | <1% | 544 | $9K | |
| 99381 | <1% | 72 | $6K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 65 | $5K |
| 96127 | <1% | 378 | $3K | |
| 83655 | <1% | 141 | $2K | |
| 85018 | <1% | 608 | $2K | |
| 81003 | <1% | 225 | $534.50 | |
| 82465 | <1% | 36 | $168.02 | |
| 83718 | <1% | 14 | $113.25 | |
| 90670 | 0% | 93 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 1,663 | $0.00 |
| 90647 | 0% | 13 | $0.00 | |
| 90686 | 0% | 143 | $0.00 | |
| 90680 | 0% | 13 | $0.00 | |
| 90723 | 0% | 13 | $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 officialSHAH, GAURANG (MEDICAL DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Tri-County Pediatrics LLC | Rock Hill, SC | $13.82M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.