Supplier
Third Street Community Clinic, INC.
Third Street Community Clinic, INC. was paid $12.93M by Medicaid between Jan 2018 and Dec 2024, across 106 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 64% of everything it billed.
33Billing provider infoTHIRD STREET COMMUNITY CLINIC, INC.
MANSFIELD, OH 44906
MANSFIELD, OH 44906
33aNPI1336252519assigned 08/15/2006
33bProvider typeClinic Pharmacy
28Total paid$12.93M
24GClaims456,800
24DCodes billed106
24AFirst – last monthJan 2018 – Dec 2024
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ANDERSON, PEGGY controls 15+ related entities in our dataset. Read more
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 | 80,380 | $2.04M | |
| 2019 | 74,746 | $2.23M | |
| 2020 | 60,892 | $1.90M | |
| 2021 | 67,283 | $2.06M | |
| 2022 | 68,513 | $1.90M | |
| 2023 | 79,578 | $1.94M | |
| 2024incomplete | 25,408 | $840K |
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 | 64% | 135,873 | 99,851 | $8.29M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.7% | 65,485 | 37,647 | $1.25M |
| 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% | 38,587 | 23,159 | $1.09M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 2.6% | 18,287 | 8,162 | $338K |
| D7140 | Extraction, erupted tooth or exposed root | 1.9% | 15,162 | 8,174 | $246K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.7% | 9,591 | 4,830 | $217K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.3% | 5,035 | 2,263 | $172K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 3,294 | 1,647 | $121K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 4,845 | 4,039 | $109K |
| D0140 | Limited oral evaluation - problem focused | <1% | 18,380 | 13,372 | $108K |
| D0330 | Panoramic radiographic image | <1% | 10,861 | 7,929 | $105K |
| D1110 | Prophylaxis - adult | <1% | 10,627 | 8,139 | $95K |
94 more codes
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,337 | $65K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 3,632 | $54K |
| D1120 | Dental cleaning, child | <1% | 7,436 | $53K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,274 | $52K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 7,103 | $51K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 5,833 | $43K |
| D1206 | Topical application of fluoride varnish | <1% | 4,383 | $36K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,567 | $35K |
| D0274 | Bitewings - four radiographic images | <1% | 8,817 | $34K |
| D0120 | Dental checkup, returning patient | <1% | 6,451 | $32K |
| 11056 | <1% | 2,565 | $28K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 2,198 | $26K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 5,854 | $21K |
| 90677 | <1% | 123 | $18K | |
| Q3014 | Telehealth originating site facility fee | <1% | 2,012 | $17K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 12,462 | $16K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 489 | $15K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,342 | $14K |
| 99442 | <1% | 1,058 | $11K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 440 | $11K |
| D1351 | Sealant - per tooth | <1% | 1,765 | $10K |
| 11720 | <1% | 2,462 | $10K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,260 | $8K |
| 90686 | <1% | 1,438 | $8K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 1,539 | $7K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 322 | $7K |
| 11721 | <1% | 1,020 | $7K | |
| D0272 | Bitewings - two radiographic images | <1% | 1,618 | $6K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 157 | $6K |
| 0012A | <1% | 160 | $6K | |
| 0011A | <1% | 149 | $5K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 293 | $5K |
| 73630 | <1% | 541 | $5K | |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 58 | $4K |
| 90674 | <1% | 362 | $4K | |
| 99406 | <1% | 1,080 | $4K | |
| L3020 | Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each | <1% | 92 | $4K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 99 | $3K |
| 99441 | <1% | 491 | $3K | |
| 99443 | <1% | 245 | $3K | |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 43 | $3K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | <1% | 135 | $2K |
| 90756 | <1% | 230 | $2K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 67 | $2K |
| 90732 | <1% | 22 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 522 | $1K |
| J2315 | Injection, naltrexone, depot form, 1 mg | <1% | 921 | $1K |
| 99402 | <1% | 122 | $1K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 156 | $1K |
| 99403 | <1% | 54 | $991.30 | |
| 90714 | <1% | 88 | $946.12 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 32 | $939.98 |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 27 | $850.23 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 38 | $845.90 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 29 | $825.69 |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 14 | $802.26 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 40 | $634.79 |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 60 | $632.26 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 831 | $450.00 |
| 90661 | <1% | 12 | $222.94 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 40 | $200.93 |
| T2003 | Non-emergency transportation, per trip | <1% | 47 | $163.28 |
| D0270 | <1% | 109 | $90.00 | |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 13 | $65.12 |
| 90461 | <1% | 741 | $31.50 | |
| 81002 | <1% | 25 | $29.10 | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 928 | $15.12 |
| 91301 | <1% | 539 | $4.96 | |
| 91300 | <1% | 32 | $0.29 | |
| 1160F | 0% | 5,277 | $0.00 | |
| 3077F | 0% | 601 | $0.00 | |
| D1999 | 0% | 6,396 | $0.00 | |
| 90648 | 0% | 53 | $0.00 | |
| 90633 | 0% | 53 | $0.00 | |
| 3078F | 0% | 305 | $0.00 | |
| 90734 | 0% | 23 | $0.00 | |
| D9110 | 0% | 16 | $0.00 | |
| 90670 | 0% | 54 | $0.00 | |
| D2332 | 0% | 16 | $0.00 | |
| 3074F | 0% | 617 | $0.00 | |
| D1330 | 0% | 3,924 | $0.00 | |
| D0601 | 0% | 341 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 25 | $0.00 |
| 3079F | 0% | 590 | $0.00 | |
| 3080F | 0% | 249 | $0.00 | |
| D0603 | 0% | 356 | $0.00 | |
| 1036F | 0% | 38 | $0.00 | |
| 3044F | 0% | 158 | $0.00 | |
| D3120 | 0% | 92 | $0.00 | |
| 90651 | 0% | 24 | $0.00 | |
| D2331 | 0% | 21 | $0.00 | |
| 90723 | 0% | 15 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 47 | $0.00 |
| D2330 | 0% | 38 | $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 officialANDERSON, PEGGY (CEO)
| Provider | Location | Paid |
|---|---|---|
| Third Street Community Clinic, INC. | Mansfield, OH | $5.21M |
| Third Street Community Clinic INC | Shelby, OH | $2.81M |
| Third Street Community Clinic INC | Mansfield, OH | $2.80M |
| Third Street Community Clinic, INC | Mansfield, OH | $1.39M |
| Third Street Community Clinic, INC. | Ontario, OH | $774K |
| Third Street Dental Mobile Van | Mansfield, OH | $746K |
| Third Street Community Clinic, INC | Bucyrus, OH | $593K |
| Third Street Community Clinic, INC. | Ashland, OH | $462K |
| Third Street Community Clinic, INC. | Bucyrus, OH | $400K |
| Third Street Community Clinic, INC. | Ashland, OH | $378K |
| Third Street Community Clinic, INC. | Mansfield, OH | $306K |
| Alliance Ob Gyn Specialists PLLC | Denton, TX | $297K |
| Third Street Community Clinic INC | Marion, OH | $234K |
| Third Street Community Clinic, INC | Mansfield, OH | $54K |
| Surgical Caregivers of Fort Worth LLC | Fort Worth, TX | $1K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.