Tri-State Ophthalmology Associates PSC
Tri-State Ophthalmology Associates PSC was paid $305K by Medicaid between Jan 2018 and Sep 2024, across 8 billing codes. Its largest line is 66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis — 80% of everything it billed.
33Billing provider infoTRI-STATE OPHTHALMOLOGY ASSOCIATES PSC
ASHLAND, KY 41101
ASHLAND, KY 41101
33aNPI1245261833assigned 07/05/2006
33bProvider typeOptometrist
28Total paid$305K
24GClaims3,778
24DCodes billed8
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Optometrist providers in Kentucky
Rank by total paid#183 of 683
Median peer was paid$123K
This provider vs. median2.5×
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 | 920 | $96K | |
| 2019 | 1,207 | $103K | |
| 2020 | 1,022 | $87K | |
| 2021 | 213 | $8K | |
| 2022 | 170 | $4K | |
| 2023 | 139 | $5K | |
| 2024incomplete | 107 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 80% | 1,200 | 862 | $245K |
| 92136 | 6.1% | 1,186 | 1,020 | $19K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 5.1% | 466 | 428 | $16K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.4% | 335 | 288 | $10K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.4% | 109 | 101 | $7K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 2.2% | 262 | 225 | $7K |
| 92015 | Determination of refractive state | <1% | 200 | 172 | $1K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 20 | 14 | $438.44 |
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 officialGROSS, JOHN (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Parkers Chapel School | El Dorado, AR | $92K |
| Carolina Macular and Retinal Care LLC | Mt Pleasant, SC | $4K |
| Gateway Pharmacy of Clare INC | Clare, MI | $1K |
| Swartz Creek Family Pharmacy LLC | Swartz Creek, MI | $695.60 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.