Clinic
Tri-State Community Health Center, INC
Tri-State Community Health Center, INC was paid $355K by Medicaid between Jan 2018 and Oct 2024, across 13 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 87% of everything it billed.
33Billing provider infoTRI-STATE COMMUNITY HEALTH CENTER, INC
CUMBERLAND, MD 21502
CUMBERLAND, MD 21502
33aNPI1457301939assigned 05/12/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$355K
24GClaims12,170
24DCodes billed13
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Maryland
Rank by total paid#19 of 34
Median peer was paid$741K
This provider vs. median0.5×
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 | 1,718 | $83K | |
| 2019 | 713 | $26K | |
| 2020 | 6,771 | $62K | |
| 2021 | 1,016 | $52K | |
| 2022 | 965 | $54K | |
| 2023 | 631 | $52K | |
| 2024incomplete | 356 | $26K |
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 | 87% | 3,514 | 3,100 | $307K |
| 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 | 8.4% | 4,718 | 1,989 | $30K |
| 36415 | Collection of venous blood by venipuncture | 3.1% | 1,685 | 671 | $11K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.4% | 1,304 | 545 | $5K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 177 | 45 | $1K |
| 90688 | <1% | 13 | 12 | $257.98 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 127 | 26 | $257.98 |
| 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 | 0% | 242 | 213 | $0.00 |
| 93000 | 0% | 81 | 12 | $0.00 | |
| 96127 | 0% | 246 | 33 | $0.00 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 0% | 14 | 12 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 34 | 14 | $0.00 |
1 more codes
| 81003 | 0% | 15 | $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 | Hancock, MD | $5.81M |
| 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-Hosp Physicians Practice | Cumberland, MD | $89K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.