Physician
Tri State Clinic, INC.
Tri State Clinic, INC. was paid $261K by Medicaid between Jan 2018 and Dec 2023, across 14 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 53% of everything it billed.
33Billing provider infoTRI STATE CLINIC, INC.
GRUNDY, VA 24614
GRUNDY, VA 24614
33aNPI1518083971assigned 03/21/2007
33bProvider typePediatrics Physician
28Total paid$261K
24GClaims10,457
24DCodes billed14
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#171 of 817
Median peer was paid$29K
This provider vs. median8.9×
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 | 1,925 | $33K | |
| 2019 | 3,460 | $70K | |
| 2020 | 2,136 | $36K | |
| 2021 | 1,357 | $47K | |
| 2022 | 1,048 | $46K | |
| 2023 | 531 | $28K |
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 | 53% | 2,557 | 2,276 | $140K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 33% | 2,465 | 2,119 | $86K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 7.6% | 4,991 | 3,047 | $20K |
| 99221 | 1.1% | 41 | 40 | $3K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 28 | 26 | $2K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 43 | 40 | $2K |
| 99218 | <1% | 26 | 25 | $2K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 99 | 26 | $2K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | <1% | 75 | 30 | $1K |
| 99223 | Prolong inpt eval add15 m | <1% | 20 | 13 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 46 | 45 | $767.17 |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 20 | 13 | $757.65 |
2 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 officialSTACY, JANET (MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Tri State Clinic, INC. | Grundy, VA | $3.83M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.