TRI-STATE MEDICAL SUPPLIES, LLC

$1.04M

Total Medicaid Paid

29,501

Total Claims

29,147

Beneficiaries

37

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
S5161	Emer rspns sys serv permonth	7,888	7,861	$236K
E0260	Hosp bed semi-electr w/ matt	2,470	2,429	$179K
K0001	Standard wheelchair	4,268	4,159	$123K
A4554	Disposable underpads	2,158	2,123	$70K
X1939		962	956	$57K
T4526	Adult size pull-on med	899	891	$44K
T4527	Adult size pull-on lg	686	679	$39K
E0601	Cont airway pressure device	709	700	$35K
T5999	Supply, nos	4,544	4,487	$34K
T4528	Adult size pull-on xl	429	425	$31K
E2386	Foam filled drive wheel tire	185	184	$23K
K0006	Heavy duty wheelchair	408	404	$23K
T4535	Disposable liner/shield/pad	750	746	$21K
E2387	Foam filled caster tire	195	195	$21K
E2395	Caster wheel excludes tire	196	195	$16K
E2321	Hand interface joystick	15	15	$14K
E2366	Battery charger, single mode	157	157	$13K
E2394	Drive wheel excludes tire	184	184	$12K
K0739	Repair/svc dme non-oxygen eq	153	153	$11K
K0195	Elevating whlchair leg rests	980	961	$9K
E2365	U1 sealed leadacid battery	59	59	$5K
E0570	Nebulizer with compression	350	347	$5K
E0303	Hosp bed hvy dty xtra wide	25	24	$4K
E2611	Gen use back cush wdth <22in	24	24	$4K
E0971	Wheelchair anti-tipping devi	121	121	$4K
E0961	Wheelchair brake extension	121	121	$2K
E0978	W/c acc,saf belt pelv strap	174	173	$2K
E0951	Loop heel	109	109	$2K
A7030	Cpap full face mask	14	14	$2K
E2601	Gen w/c cushion wdth < 22 in	53	53	$1K
K0019	Arm pad repl, each	52	52	$856.19
T4525	Adult size pull-on sm	12	12	$670.32
A7031	Replacement facemask interfa	16	16	$667.72
A7037	Pos airway pressure tubing	17	17	$373.34
A4927	Non-sterile gloves	38	25	$349.73
A7035	Pos airway press headgear	17	17	$347.88
A7038	Pos airway pressure filter	63	59	$247.17

Medicaid Provider Spending