Tri County Gastroenterology PC
Tri County Gastroenterology PC was paid $48K by Medicaid between Jan 2018 and Jul 2020, across 11 billing codes. Its largest line is 45385, Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) — 43% of everything it billed.
33Billing provider infoTRI COUNTY GASTROENTEROLOGY PC
SOUTH HILL, VA 23970
SOUTH HILL, VA 23970
33aNPI1265740492assigned 09/22/2010
33bProvider typeSpecialist
28Total paid$48K
24GClaims3,247
24DCodes billed11
24AFirst – last monthJan 2018 – Jul 2020
Compared with peers
Next to other Specialist providers in Virginia
Rank by total paid#112 of 231
Median peer was paid$47K
This provider vs. median1.0×
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 | 1,160 | $7K | |
| 2019 | 1,814 | $35K | |
| 2020 | 273 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 43% | 235 | 194 | $21K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 26% | 337 | 260 | $13K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.8% | 211 | 174 | $5K |
| 43235 | 7.5% | 114 | 93 | $4K | |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | 4.5% | 1,030 | 793 | $2K |
| 99153 | Mod sedat endo service >5yrs | 4.5% | 692 | 557 | $2K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 3.3% | 20 | 15 | $2K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1.2% | 17 | 13 | $574.99 |
| 1036F | 0% | 110 | 83 | $0.00 | |
| G9612 | Photodocumentation of two or more cecal landmarks to establish a complete examination | 0% | 164 | 114 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 317 | 227 | $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 officialALLEN, HERBERT (PRESIDENT)