Clinic
Third Street Community Clinic INC
Third Street Community Clinic INC was paid $2.81M by Medicaid between Jan 2018 and Nov 2024, across 53 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 68% of everything it billed.
33Billing provider infoTHIRD STREET COMMUNITY CLINIC INC
SHELBY, OH 44875
SHELBY, OH 44875
33aNPI1811364706assigned 08/26/2015
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$2.81M
24GClaims92,851
24DCodes billed53
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Ohio
Rank by total paid#122 of 348
Median peer was paid$1.33M
This provider vs. median2.1×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ANDERSON, PEGGY controls 15+ related entities in our dataset. Read more
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 | 13,879 | $402K | |
| 2019 | 13,246 | $437K | |
| 2020 | 12,048 | $411K | |
| 2021 | 15,795 | $531K | |
| 2022 | 16,728 | $503K | |
| 2023 | 20,722 | $510K | |
| 2024incomplete | 433 | $13K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 68% | 27,157 | 21,579 | $1.92M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 16,521 | 8,748 | $307K |
| 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 | 11% | 11,427 | 6,722 | $301K |
| D7140 | Extraction, erupted tooth or exposed root | 1.7% | 2,520 | 1,124 | $47K |
| D1110 | Prophylaxis - adult | 1.4% | 3,587 | 2,311 | $39K |
| D0330 | Panoramic radiographic image | <1% | 2,085 | 1,375 | $28K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 1,285 | 711 | $20K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 698 | 618 | $18K |
| D0140 | Limited oral evaluation - problem focused | <1% | 2,521 | 1,608 | $17K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 808 | 441 | $15K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 2,256 | 1,415 | $12K |
| D0274 | Bitewings - four radiographic images | <1% | 2,581 | 1,728 | $11K |
41 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,454 | $11K |
| D1120 | Dental cleaning, child | <1% | 1,586 | $11K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 157 | $9K |
| 99442 | <1% | 714 | $7K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 1,196 | $6K |
| D1206 | Topical application of fluoride varnish | <1% | 833 | $5K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 2,617 | $4K |
| Q3014 | Telehealth originating site facility fee | <1% | 524 | $4K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 154 | $3K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 59 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 528 | $3K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 729 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 87 | $2K |
| D1351 | Sealant - per tooth | <1% | 149 | $1K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 49 | $910.00 |
| 36415 | Collection of venous blood by venipuncture | <1% | 927 | $908.33 |
| D0272 | Bitewings - two radiographic images | <1% | 343 | $810.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 70 | $790.27 |
| 0011A | <1% | 20 | $546.84 | |
| 0012A | <1% | 15 | $545.02 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 70 | $530.35 |
| 90686 | <1% | 81 | $513.64 | |
| 90674 | <1% | 41 | $366.78 | |
| 99406 | <1% | 55 | $220.65 | |
| 90756 | <1% | 30 | $208.53 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 25 | $162.44 |
| D0270 | <1% | 107 | $150.00 | |
| 99441 | <1% | 25 | $142.09 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 88 | $90.00 |
| 91301 | <1% | 39 | $0.36 | |
| 3074F | 0% | 380 | $0.00 | |
| D1330 | 0% | 1,084 | $0.00 | |
| 3080F | 0% | 40 | $0.00 | |
| D0603 | 0% | 81 | $0.00 | |
| 3079F | 0% | 255 | $0.00 | |
| D0601 | 0% | 75 | $0.00 | |
| 1160F | 0% | 3,065 | $0.00 | |
| 3078F | 0% | 240 | $0.00 | |
| 3077F | 0% | 163 | $0.00 | |
| 1159F | 0% | 33 | $0.00 | |
| D1999 | 0% | 1,217 | $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 officialANDERSON, PEGGY (CEO)
| Provider | Location | Paid |
|---|---|---|
| Third Street Community Clinic, INC. | Mansfield, OH | $12.93M |
| Third Street Community Clinic, INC. | Mansfield, OH | $5.21M |
| Third Street Community Clinic INC | Mansfield, OH | $2.80M |
| Third Street Community Clinic, INC | Mansfield, OH | $1.39M |
| Third Street Community Clinic, INC. | Ontario, OH | $774K |
| Third Street Dental Mobile Van | Mansfield, OH | $746K |
| Third Street Community Clinic, INC | Bucyrus, OH | $593K |
| Third Street Community Clinic, INC. | Ashland, OH | $462K |
| Third Street Community Clinic, INC. | Bucyrus, OH | $400K |
| Third Street Community Clinic, INC. | Ashland, OH | $378K |
| Third Street Community Clinic, INC. | Mansfield, OH | $306K |
| Alliance Ob Gyn Specialists PLLC | Denton, TX | $297K |
| Third Street Community Clinic INC | Marion, OH | $234K |
| Third Street Community Clinic, INC | Mansfield, OH | $54K |
| Surgical Caregivers of Fort Worth LLC | Fort Worth, TX | $1K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.