Physician
Tri-State Pulmonary Associates, INC.
Tri-State Pulmonary Associates, INC. was paid $260K by Medicaid between Jan 2018 and Jun 2021, across 14 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 44% of everything it billed.
33Billing provider infoTRI-STATE PULMONARY ASSOCIATES, INC.
CINCINNATI, OH 45219
CINCINNATI, OH 45219
33aNPI1891731261assigned 06/22/2006
33bProvider typePulmonary Disease Physician
28Total paid$260K
24GClaims9,452
24DCodes billed14
24AFirst – last monthJan 2018 – Jun 2021
Compared with peers
Next to other Pulmonary Disease Physician providers in Ohio
Rank by total paid#9 of 42
Median peer was paid$34K
This provider vs. median7.6×
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 | 3,199 | $75K | |
| 2019 | 3,107 | $81K | |
| 2020 | 1,954 | $76K | |
| 2021 | 1,192 | $29K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 44% | 2,459 | 716 | $115K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 16% | 2,599 | 1,002 | $41K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 2,171 | 1,776 | $40K |
| 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 | 10% | 932 | 765 | $26K |
| 95811 | 4.7% | 242 | 209 | $12K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 4.0% | 228 | 202 | $10K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 3.6% | 367 | 180 | $9K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 1.2% | 44 | 41 | $3K |
| 94060 | <1% | 103 | 92 | $2K | |
| 94729 | <1% | 105 | 95 | $943.07 | |
| 94726 | <1% | 74 | 70 | $739.32 | |
| 3074F | 0% | 47 | 46 | $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 officialORR, MARILYN (PRACTICE MANAGER/ADMINISTRATOR)