Lab
Tri State Medical Alliance LLC
Tri State Medical Alliance LLC was paid $3K by Medicaid between Mar 2020 and Jun 2022, across 1 billing code. Its largest line is 72114, — 100% of everything it billed.
33Billing provider infoTRI STATE MEDICAL ALLIANCE LLC
FORT MOHAVE, AZ 86426
FORT MOHAVE, AZ 86426
33aNPI1518472950assigned 12/07/2017
33bProvider typePhysiological Laboratory
28Total paid$3K
24GClaims97
24DCodes billed1
24AFirst – last monthMar 2020 – Jun 2022
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 | |
|---|---|---|---|
| 2020 | 50 | $1K | |
| 2021 | 34 | $1K | |
| 2022 | 13 | $652.47 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 72114 | 100% | 97 | 86 | $3K |
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 officialTABORA, HANZ (OWNER/MEMBER MANAGER)