Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or West Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to West Virginia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. West Virginia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Tri State Medical (NPI 1720084304)

Field	Value
Entity Type	Organization
Organization	Tri State Medical
Address	3924 Main St
City	Weirton
State	WV
ZIP	26062
Taxonomy	Oxygen Equipment & Supplies (DME)
NPI Enumerated	June 28, 2005

Payer Source	Total Paid
Medicaid	$816K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	4,550	$80	$359.2K
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	2,170	$130	$288.6K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	3,070	$20	$64.6K
E0570	Nebulizer, with compressor	1,590	$30	$42.8K
E0601	Continuous positive airway pressure (CPAP) device	520	$40	$22.4K
E0114	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	370	$30	$12K
K0001	Standard wheelchair	370	$20	$8.9K
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	100	$40	$4.3K
A7038	Filter, disposable, used with positive airway pressure device	680	$1	$2.7K
E0562	Humidifier, heated, used with positive airway pressure device	50	$50	$2.7K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. West Virginia Distribution

Tri State Medical — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	14	30	2,020	$110	$1.3M
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	46	80	5,550	$60	$504.2K
A4554	Disposable underpads, all sizes	21	20	670	$20	$166.3K
E0601	Continuous positive airway pressure (CPAP) device	52	60	1,500	$40	$71K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	39	80	3,150	$10	$55.4K
E0562	Humidifier, heated, used with positive airway pressure device	37	40	820	$30	$38.7K
A4604	Tubing with integrated heating element for use with positive airway pressure device	28	30	530	$30	$31.8K
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	11	10	360	$40	$25.5K
E0570	Nebulizer, with compressor	26	80	1,100	$20	$24.2K
E0114	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	7	10	370	$30	$24K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Tri State Medical, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kirti Jain	KY	Hematology & Oncology Physician	$362.3K	$0

Nearby Providers

Other providers in the same ZIP code as Tri State Medical, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthways Inc	WV	Community/Behavioral Health Agency	$0	$40.8M
Weirton Medical Center, Inc	WV	General Acute Care Hospital	$0	$27.7M
Change, Incorporated	WV	Federally Qualified Health Center (FQHC)	$0	$21.2M
Healthways Inc	WV	Community/Behavioral Health Agency	$0	$3M
First Steps Pediatrics & Adolescent Medicine PLLC	WV	Pediatrics Physician	$0	$2.5M
Hancock County Sheltered Workshop Inc.	WV	Community/Behavioral Health Agency	$0	$2.1M
Health Care Solutions At Home Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$1.8M
Family Connections	WV	Mental Health Counselor	$0	$818.8K
Christopher Kolibash	WV	Clinical Cardiac Electrophysiology Physician	$425.8K	$48K
Maninder Bedi	WV	Cardiovascular Disease Physician	$416.1K	$53.8K

Tri State Medical — Billing Profile & Reimbursement Data

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Tri State Medical — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References