Physician
Tri-Rivers Healthcare PLLC
Tri-Rivers Healthcare PLLC was paid $522K by Medicaid between Jan 2018 and Dec 2024, across 31 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 89% of everything it billed.
33Billing provider infoTRI-RIVERS HEALTHCARE PLLC
MARION, KY 42064
MARION, KY 42064
33aNPI1699895003assigned 03/30/2007
33bProvider typeGeneral Practice Physician
28Total paid$522K
24GClaims57,567
24DCodes billed31
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Physician providers in Kentucky
Rank by total paid#3 of 25
Median peer was paid$50K
This provider vs. median11×
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 | 3,353 | $72K | |
| 2019 | 4,382 | $79K | |
| 2020 | 3,635 | $78K | |
| 2021 | 4,980 | $73K | |
| 2022 | 10,803 | $81K | |
| 2023 | 19,275 | $79K | |
| 2024incomplete | 11,139 | $60K |
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 | 89% | 16,496 | 12,137 | $463K |
| 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 | 2.1% | 218 | 183 | $11K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 2.0% | 471 | 300 | $10K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.7% | 351 | 251 | $9K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 1.2% | 356 | 258 | $7K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 138 | 124 | $5K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 338 | 256 | $5K |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 69 | 60 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 186 | 164 | $2K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 32 | 28 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 151 | 130 | $2K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 75 | 62 | $1K |
19 more codes
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 297 | $1K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 78 | $655.80 |
| 3077F | <1% | 230 | $164.74 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 77 | $139.56 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 14 | $70.26 |
| 81002 | <1% | 57 | $64.67 | |
| 3008F | <1% | 7,403 | $2.47 | |
| 3074F | <1% | 6,126 | $1.57 | |
| 3078F | <1% | 4,969 | $1.11 | |
| 3079F | <1% | 937 | $0.22 | |
| 1126F | <1% | 2,706 | $0.07 | |
| 1125F | <1% | 1,841 | $0.05 | |
| 1036F | 0% | 3,482 | $0.00 | |
| 1034F | 0% | 494 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 32 | $0.00 |
| 3075F | 0% | 31 | $0.00 | |
| 1159F | 0% | 4,214 | $0.00 | |
| 1160F | 0% | 5,563 | $0.00 | |
| 3725F | 0% | 135 | $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)
| Provider | Location | Paid |
|---|---|---|
| Tri-Rivers Healthcare PLLC | Salem, KY | $738K |
| Tri-Rivers Healthcare PLLC | Smithland, KY | $437K |
| Tri-Rivers Healthcare, PLLC | Salem, KY | $280K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.