THIRD STREET COMMUNITY CLINIC INC

NPI: 1972053452 · MANSFIELD, OH 44902 · Federally Qualified Health Center (FQHC) · NPI assigned 10/10/2016

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official ANDERSON, PEGGY controls 15+ related entities in our dataset. Read more

$2.80M

Total Medicaid Paid

81,829

Total Claims

52,245

Beneficiaries

Codes Billed

2018-01

First Month

2024-12

Last Month

Provider Details

Authorized Official	ANDERSON, PEGGY (CEO)
NPI Enumeration Date	10/10/2016

Related Entities

Other providers sharing the same authorized official: ANDERSON, PEGGY

Provider	City	State	Total Paid
THIRD STREET COMMUNITY CLINIC, INC.	MANSFIELD	OH	$12.93M
THIRD STREET COMMUNITY CLINIC, INC.	MANSFIELD	OH	$5.21M
THIRD STREET COMMUNITY CLINIC INC	SHELBY	OH	$2.81M
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

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2018	12,381	$397K
2019	12,219	$480K
2020	13,369	$487K
2021	13,690	$508K
2022	13,179	$443K
2023	13,549	$362K
2024	3,442	$122K

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	25,955	20,249	$1.80M
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	19,028	10,849	$525K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	21,516	12,059	$407K
99406		3,361	1,891	$12K
90792	Psychiatric diagnostic evaluation with medical services	344	146	$8K
Q3014	Telehealth originating site facility fee	660	311	$6K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	420	281	$5K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	162	81	$5K
G0467	Federally 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	163	142	$5K
99442		445	212	$4K
J2315	Injection, naltrexone, depot form, 1 mg	345	204	$4K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	784	446	$4K
90686		359	218	$3K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	364	209	$3K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	116	56	$2K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	61	31	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	214	142	$2K
36415	Collection of venous blood by venipuncture	1,600	899	$2K
83036	Hemoglobin; glycosylated (A1C)	481	299	$1K
87636	Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B	25	14	$1K
90674		116	74	$1K
96127		700	391	$665.28
90661		13	12	$445.88
91301		45	43	$0.41
3079F		529	381	$0.00
3074F		506	389	$0.00
3075F		47	32	$0.00
3080F		163	106	$0.00
3044F		16	13	$0.00
1036F		101	96	$0.00
3078F		223	184	$0.00
3077F		291	180	$0.00
1160F		2,631	1,566	$0.00
1159F		45	39	$0.00