Physician
Tri-State Gastroenterology Associates, PSC
Tri-State Gastroenterology Associates, PSC was paid $1.25M by Medicaid between Jan 2018 and Nov 2024, across 16 billing codes. Its largest line is 88305, Level IV - Surgical pathology, gross and microscopic examination — 47% of everything it billed.
33Billing provider infoTRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC
CRESTVIEW HILLS, KY 41017
CRESTVIEW HILLS, KY 41017
33aNPI1306843842assigned 06/30/2005
33bProvider typeGastroenterology Physician
28Total paid$1.25M
24GClaims21,535
24DCodes billed16
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Gastroenterology Physician providers in Kentucky
Rank by total paid#2 of 23
Median peer was paid$116K
This provider vs. median11×
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 | 4,380 | $209K | |
| 2019 | 3,432 | $203K | |
| 2020 | 2,834 | $169K | |
| 2021 | 4,201 | $221K | |
| 2022 | 2,928 | $181K | |
| 2023 | 2,364 | $150K | |
| 2024incomplete | 1,396 | $121K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 47% | 7,196 | 5,251 | $595K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 15% | 2,362 | 1,931 | $183K |
| 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 | 8.5% | 2,734 | 2,450 | $107K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 6.3% | 3,412 | 1,795 | $79K |
| 88312 | 6.1% | 1,642 | 1,161 | $76K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 5.8% | 887 | 805 | $72K |
| 88313 | 4.4% | 1,357 | 922 | $55K | |
| 99222 | Initial hospital care, per day, moderate complexity | 2.4% | 550 | 476 | $31K |
| 99254 | 1.3% | 173 | 154 | $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 | <1% | 488 | 430 | $12K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 58 | 51 | $7K |
| 99221 | <1% | 201 | 171 | $7K |
4 more codes
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 officialFAGEL, DANIEL (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Tri-State Gastroenterology Associates, PSC | Crestview Hills, KY | $1.92M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.