Physician
Tri-Rivers Healthcare, PLLC
Tri-Rivers Healthcare, PLLC was paid $280K by Medicaid between Jan 2018 and Nov 2024, across 25 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 61% of everything it billed.
33Billing provider infoTRI-RIVERS HEALTHCARE, PLLC
SALEM, KY 42078
SALEM, KY 42078
33aNPI1649592304assigned 02/23/2010
33bProvider typeEmergency Medicine Physician
28Total paid$280K
24GClaims10,264
24DCodes billed25
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Emergency Medicine Physician providers in Kentucky
Rank by total paid#24 of 91
Median peer was paid$34K
This provider vs. median8.2×
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 | 1,155 | $46K | |
| 2019 | 1,420 | $57K | |
| 2020 | 695 | $29K | |
| 2021 | 922 | $32K | |
| 2022 | 1,420 | $27K | |
| 2023 | 3,196 | $66K | |
| 2024incomplete | 1,456 | $25K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 61% | 2,016 | 1,646 | $170K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 1,521 | 1,232 | $42K |
| 43249 | 13% | 294 | 244 | $37K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 5.2% | 2,539 | 1,550 | $15K |
| 99219 | 2.0% | 172 | 123 | $6K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.6% | 247 | 98 | $4K |
| 99220 | <1% | 68 | 44 | $2K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 78 | 52 | $1K |
| 43248 | <1% | 24 | 13 | $1K | |
| 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 | <1% | 17 | 14 | $792.33 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 150 | 71 | $566.18 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 51 | 38 | $496.39 |
13 more codes
| 99217 | <1% | 19 | $434.64 | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 17 | $260.17 |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 41 | $59.51 |
| 3008F | <1% | 683 | $0.60 | |
| 3074F | <1% | 374 | $0.08 | |
| 3078F | <1% | 313 | $0.06 | |
| 1034F | 0% | 17 | $0.00 | |
| 1036F | 0% | 288 | $0.00 | |
| 1126F | 0% | 218 | $0.00 | |
| 1125F | 0% | 107 | $0.00 | |
| 3079F | 0% | 27 | $0.00 | |
| 1160F | 0% | 557 | $0.00 | |
| 1159F | 0% | 426 | $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 officialHENEISEN, MICHAEL (AGENT / BUSINESS MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Tri-Rivers Healthcare PLLC | Salem, KY | $738K |
| Tri-Rivers Healthcare PLLC | Marion, KY | $522K |
| Tri-Rivers Healthcare PLLC | Smithland, KY | $437K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.