Clinic
Tri-State Community Health Center, INC
Tri-State Community Health Center, INC was paid $5.81M by Medicaid between Jan 2018 and Oct 2024, across 32 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 45% of everything it billed.
33Billing provider infoTRI-STATE COMMUNITY HEALTH CENTER, INC
HANCOCK, MD 21750
HANCOCK, MD 21750
33aNPI1366491201assigned 05/09/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$5.81M
24GClaims98,150
24DCodes billed32
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Maryland
Rank by total paid#14 of 34
Median peer was paid$741K
This provider vs. median7.8×
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 | 3,294 | $64K | |
| 2019 | 2,474 | $57K | |
| 2020 | 20,431 | $1.06M | |
| 2021 | 19,252 | $1.24M | |
| 2022 | 21,549 | $1.27M | |
| 2023 | 19,466 | $1.23M | |
| 2024incomplete | 11,684 | $901K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 45% | 22,831 | 18,283 | $2.60M |
| 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 | 34% | 16,715 | 14,590 | $1.96M |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 10% | 15,940 | 14,090 | $609K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 4.9% | 2,169 | 2,113 | $286K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.9% | 811 | 798 | $112K |
| 59430 | 1.8% | 781 | 688 | $104K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.5% | 621 | 602 | $85K |
| 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 | <1% | 115 | 115 | $14K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,666 | 5,780 | $7K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,526 | 1,496 | $7K |
| 99385 | <1% | 56 | 53 | $7K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,687 | 2,549 | $4K |
20 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 26 | $3K |
| 87428 | <1% | 851 | $2K | |
| 96127 | <1% | 438 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 14 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 72 | $843.28 |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 275 | $580.00 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 40 | $325.92 |
| 90715 | <1% | 107 | $256.08 | |
| 81025 | <1% | 3,145 | $50.25 | |
| 90686 | <1% | 605 | $27.97 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,685 | $24.22 |
| 81003 | <1% | 1,700 | $17.20 | |
| 93000 | <1% | 150 | $15.68 | |
| 81002 | <1% | 6,713 | $10.56 | |
| 99000 | <1% | 9,341 | $8.76 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 119 | $0.00 |
| 94760 | 0% | 183 | $0.00 | |
| 92551 | 0% | 46 | $0.00 | |
| 99406 | 0% | 13 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 1,709 | $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 officialDESHONG, SHEILA (EXECUTIVE DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Tri-State Community Health Center, INC | Berkeley Springs, WV | $1.69M |
| Tri-State Community Health Center, INC | Mcconnellsburg, PA | $1.68M |
| Tri-State Community Health Center, INC | Cumberland, MD | $741K |
| Tri-State Community Health Center, INC | Cumberland, MD | $355K |
| Tri-State Community Health Center-Hosp Physicians Practice | Cumberland, MD | $89K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.