Clinic
Tri-State Community Health Center, INC
Tri-State Community Health Center, INC was paid $1.68M by Medicaid between Jan 2018 and Oct 2024, across 20 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoTRI-STATE COMMUNITY HEALTH CENTER, INC
MCCONNELLSBURG, PA 17233
MCCONNELLSBURG, PA 17233
33aNPI1932159464assigned 05/12/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$1.68M
24GClaims30,478
24DCodes billed20
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Pennsylvania
Rank by total paid#94 of 240
Median peer was paid$909K
This provider vs. median1.8×
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 | 1,242 | $38K | |
| 2019 | 1,098 | $45K | |
| 2020 | 1,938 | $108K | |
| 2021 | 7,858 | $472K | |
| 2022 | 7,138 | $395K | |
| 2023 | 6,449 | $345K | |
| 2024incomplete | 4,755 | $273K |
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 | 99% | 16,735 | 14,202 | $1.66M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 6,830 | 6,034 | $12K |
| 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 | <1% | 3,055 | 2,797 | $2K |
| 94760 | 0% | 909 | 827 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 876 | 871 | $0.00 |
| 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 | 0% | 111 | 92 | $0.00 |
| 99000 | 0% | 190 | 183 | $0.00 | |
| 92551 | 0% | 118 | 115 | $0.00 | |
| 87428 | 0% | 322 | 307 | $0.00 | |
| 90686 | 0% | 14 | 14 | $0.00 | |
| 81003 | 0% | 57 | 55 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 387 | 384 | $0.00 |
8 more codes
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 0% | 101 | $0.00 |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 222 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 235 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 68 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 155 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 27 | $0.00 |
| 99173 | 0% | 17 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 49 | $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 officialDESHONG, SHEILA (EXECUTIVE DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Tri-State Community Health Center, INC | Hancock, MD | $5.81M |
| Tri-State Community Health Center, INC | Berkeley Springs, WV | $1.69M |
| Tri-State Community Health Center, INC | Cumberland, MD | $741K |
| Tri-State Community Health Center, INC | Cumberland, MD | $355K |
| Tri-State Community Health Center-Hosp Physicians Practice | Cumberland, MD | $89K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.