Clinic
Triangle Gastroenterology PLLC
Triangle Gastroenterology PLLC was paid $169K by Medicaid between Jan 2018 and Nov 2024, across 8 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 41% of everything it billed.
33Billing provider infoTRIANGLE GASTROENTEROLOGY PLLC
RALEIGH, NC 27604
RALEIGH, NC 27604
33aNPI1417911322assigned 04/17/2006
33bProvider typeAmbulatory Surgical Clinic/Center
28Total paid$169K
24GClaims2,245
24DCodes billed8
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Ambulatory Surgical Clinic/Center providers in North Carolina
Rank by total paid#36 of 89
Median peer was paid$104K
This provider vs. median1.6×
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 | 411 | $35K | |
| 2019 | 192 | $11K | |
| 2020 | 132 | $10K | |
| 2021 | 183 | $11K | |
| 2022 | 230 | $15K | |
| 2023 | 487 | $36K | |
| 2024incomplete | 610 | $50K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 41% | 466 | 323 | $69K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 20% | 554 | 364 | $34K |
| 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 | 17% | 390 | 292 | $29K |
| 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 | 9.8% | 352 | 275 | $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 | 7.6% | 406 | 276 | $13K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 2.6% | 14 | 14 | $4K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 1.7% | 15 | 12 | $3K |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility | 0% | 48 | 42 | $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 officialDOSHI, HIRENDRA (OWNER MD)