Tri State Surgical Associates PLLC
Tri State Surgical Associates PLLC was paid $2.27M by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 54% of everything it billed.
33Billing provider infoTRI STATE SURGICAL ASSOCIATES PLLC
MIDDLETOWN, NY 10941
MIDDLETOWN, NY 10941
33aNPI1801993175assigned 09/20/2006
33bProvider typeSpecialist
28Total paid$2.27M
24GClaims27,426
24DCodes billed15
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in New York
Rank by total paid#81 of 1,221
Median peer was paid$45K
This provider vs. median50×
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 | 2,670 | $255K | |
| 2019 | 3,297 | $278K | |
| 2020 | 3,443 | $263K | |
| 2021 | 5,054 | $430K | |
| 2022 | 5,187 | $427K | |
| 2023 | 4,846 | $382K | |
| 2024incomplete | 2,929 | $232K |
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 | 54% | 16,879 | 15,121 | $1.23M |
| 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 | 22% | 4,851 | 4,594 | $489K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 12% | 2,117 | 1,983 | $267K |
| 74240 | 6.7% | 1,968 | 1,954 | $153K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.5% | 376 | 376 | $56K |
| 99443 | 2.1% | 536 | 521 | $47K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 97 | 97 | $12K |
| 43775 | <1% | 12 | 12 | $7K | |
| 99442 | <1% | 37 | 36 | $2K | |
| 99205 | Prolong outpt/office vis | <1% | 12 | 12 | $2K |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 61 | 59 | $2K |
| T1013 | Sign language or oral interpretive services, per 15 minutes | <1% | 102 | 100 | $1K |
3 more codes
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 officialKOWAL, GINA (BILLING MANAGER)