NP / PA
Tri State Medical Clinic INC
Tri State Medical Clinic INC was paid $1.26M by Medicaid between Jan 2018 and Dec 2024, across 29 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 68% of everything it billed.
33Billing provider infoTRI STATE MEDICAL CLINIC INC
MIDDLESBORO, KY 40965
MIDDLESBORO, KY 40965
33aNPI1649370719assigned 09/25/2006
33bProvider typeFamily Nurse Practitioner
28Total paid$1.26M
24GClaims49,413
24DCodes billed29
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Nurse Practitioner providers in Kentucky
Rank by total paid#15 of 424
Median peer was paid$19K
This provider vs. median67×
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 | 5,886 | $147K | |
| 2019 | 7,010 | $151K | |
| 2020 | 7,341 | $204K | |
| 2021 | 9,766 | $248K | |
| 2022 | 6,956 | $201K | |
| 2023 | 7,033 | $166K | |
| 2024incomplete | 5,421 | $140K |
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 | 68% | 32,528 | 24,610 | $856K |
| 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 | 7.5% | 2,912 | 2,389 | $94K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.0% | 3,006 | 2,500 | $62K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 4.7% | 1,993 | 1,610 | $58K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 4.4% | 571 | 545 | $55K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.6% | 631 | 564 | $33K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.7% | 1,304 | 991 | $21K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.6% | 1,379 | 1,148 | $20K |
| 87428 | 1.4% | 296 | 278 | $18K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 647 | 524 | $7K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 332 | 312 | $6K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 760 | 717 | $5K |
17 more codes
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 146 | $5K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 131 | $5K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 391 | $3K |
| 90674 | <1% | 150 | $2K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 407 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 94 | $1K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 20 | $970.85 |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 30 | $936.46 |
| 99201 | <1% | 26 | $534.18 | |
| 90686 | <1% | 17 | $232.41 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 154 | $94.36 |
| A4206 | Syringe with needle, sterile, 1 cc or less, each | <1% | 1,253 | $75.43 |
| 81002 | <1% | 44 | $35.55 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 13 | $25.34 |
| 87807 | <1% | 12 | $12.70 | |
| G0008 | Administration of influenza virus vaccine | <1% | 18 | $8.44 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 148 | $0.07 |
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 officialROARK, LARRY (NURSE PRACTITIONER/OWNER)