Tri-State Digestive Disease Assoc PSC.

Tri-State Digestive Disease Assoc PSC. was paid $143K by Medicaid between Jan 2018 and May 2024, across 8 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 48% of everything it billed.

33Billing provider infoTRI-STATE DIGESTIVE DISEASE ASSOC PSC.
ASHLAND, KY 41101

33aNPI1851467237assigned 11/28/2006

33bProvider typeGastroenterology Physician

28Total paid$143K

24GClaims3,786

24DCodes billed8

24AFirst – last monthJan 2018 – May 2024

Compared with peers

Next to other Gastroenterology Physician providers in Kentucky

Rank by total paid#11 of 23

Median peer was paid$116K

This provider vs. median1.2×

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	988	$41K
2019	898	$30K
2020	577	$22K
2021	489	$16K
2022	517	$22K
2023	272	$10K
2024incomplete	45	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	48%	1,011	932	$69K
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	25%	1,408	1,295	$36K
45380	Colonoscopy, flexible; with biopsy, single or multiple	11%	108	100	$15K
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)	5.5%	670	636	$8K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	5.1%	467	428	$7K
99244	Office or other outpatient consultation, moderate to high complexity	2.2%	44	39	$3K
99222	Initial hospital care, per day, moderate complexity	1.6%	65	65	$2K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	1.4%	13	13	$2K

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 officialCANTY, MICHAEL (PRESIDENT)