Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

State of Franklin Healthcare Associates PLLC

State of Franklin Healthcare Associates PLLC was paid $23.19M by Medicaid between Jan 2018 and Dec 2024, across 215 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 24% of everything it billed.

33Billing provider infoSTATE OF FRANKLIN HEALTHCARE ASSOCIATES PLLC
JOHNSON CITY, TN 37601
33aNPI1063459410assigned 06/01/2006
33bProvider typeFamily Medicine Physician
28Total paid$23.19M
24GClaims921,567
24DCodes billed215
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Family Medicine Physician providers in Tennessee

Rank by total paid#5 of 754
Median peer was paid$34K
This provider vs. median687×

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

$0$200K$400K$600K2018201920202021202220232024
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
YearClaimsPaid
201879,293$1.48M
201992,639$1.77M
2020104,080$2.32M
2021142,076$3.90M
2022163,463$4.55M
2023178,631$4.87M
2024incomplete161,385$4.30M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 24% 127,333 106,997 $5.64M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 20% 122,233 105,976 $4.75M
90460 Immunization administration through 18 years of age via any route, first or only component 7.7% 37,732 33,701 $1.78M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 5.7% 19,245 17,737 $1.32M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 5.5% 21,579 18,275 $1.27M
96110 Developmental screening, with scoring and documentation, per standardized instrument 4.4% 36,117 33,356 $1.02M
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 3.2% 22,313 20,205 $751K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 3.2% 16,135 14,924 $739K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2.8% 9,834 8,876 $652K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 2.8% 11,925 9,935 $646K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1.5% 19,916 14,325 $355K
96160 1.5% 20,145 11,773 $344K
203 more codes
99233 Hospital visit by a doctor, follow-up day (complex) 1.4% 15,414 $315K
59025 Fetal non-stress test 1.1% 8,667 $245K
99232 Hospital visit by a doctor, follow-up day <1% 16,266 $214K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 2,477 $177K
96161 <1% 12,431 $173K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 1,672 $146K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 4,219 $135K
92552 <1% 7,798 $134K
99223 Prolong inpt eval add15 m <1% 3,069 $134K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 1,640 $112K
76819 Fetal biophysical profile; without non-stress testing <1% 1,607 $100K
0503F <1% 2,970 $97K
99308 Subsequent nursing facility care, per day, straightforward <1% 15,660 $94K
99239 Hospital discharge day management, more than 30 minutes <1% 4,082 $93K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 15,752 $90K
77067 Screening mammography, bilateral, including computer-aided detection <1% 1,818 $85K
99204 Doctor's office visit, new patient (more involved) <1% 990 $77K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 2,781 $71K
36415 Collection of venous blood by venipuncture <1% 42,895 $67K
96127 <1% 13,537 $61K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 1,913 $60K
71046 Radiologic examination, chest; 2 views <1% 4,317 $53K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care <1% 37 $51K
99203 Doctor's office visit, new patient (routine) <1% 863 $50K
76801 <1% 669 $48K
81025 <1% 8,238 $48K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 6,871 $46K
99215 Doctor's office visit, returning patient (complex) <1% 460 $42K
76641 <1% 575 $37K
77063 Screening digital breast tomosynthesis, bilateral <1% 1,859 $36K
76830 Ultrasound, transvaginal <1% 468 $35K
87807 <1% 2,854 $32K
99220 <1% 497 $32K
95911 <1% 255 $29K
95886 <1% 714 $27K
80081 <1% 371 $27K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 2,283 $26K
99177 <1% 3,545 $26K
0500F <1% 2,327 $24K
80061 Lipid panel <1% 4,414 $22K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 340 $21K
90677 <1% 1,663 $21K
80053 Comprehensive metabolic panel <1% 7,559 $20K
87634 <1% 330 $19K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 345 $19K
99173 <1% 3,358 $19K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 460 $18K
99385 <1% 187 $15K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 112 $15K
99349 <1% 866 $14K
90670 <1% 8,019 $13K
90686 <1% 9,827 $13K
74018 <1% 803 $12K
62323 <1% 185 $12K
99307 <1% 2,818 $12K
85018 <1% 4,251 $11K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 1,227 $11K
80050 General health panel <1% 662 $10K
83655 <1% 797 $10K
99383 <1% 129 $9K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 501 $9K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 1,005 $9K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B <1% 76 $9K
72100 <1% 538 $7K
3008F <1% 10,031 $7K
85014 <1% 2,641 $7K
73630 <1% 578 $7K
84443 Thyroid stimulating hormone (TSH) <1% 821 $7K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 214 $7K
76536 <1% 184 $6K
59426 <1% 13 $6K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 293 $6K
99459 <1% 361 $5K
90723 <1% 3,518 $5K
0502F <1% 80,895 $5K
99219 <1% 78 $5K
36416 <1% 2,436 $5K
59430 <1% 1,436 $5K
76642 <1% 112 $5K
90651 <1% 332 $5K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 1,478 $5K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 121 $5K
80305 <1% 413 $4K
86803 <1% 371 $4K
99222 Initial hospital care, per day, moderate complexity <1% 70 $4K
87581 <1% 109 $4K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 13 $4K
83036 Hemoglobin; glycosylated (A1C) <1% 1,584 $4K
99238 Hospital discharge day management, 30 minutes or less <1% 124 $4K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 1,570 $4K
A9585 Injection, gadobutrol, 0.1 ml <1% 219 $3K
90647 <1% 1,956 $3K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 32 $3K
77066 Tomosynthesis, mammo <1% 39 $3K
90674 <1% 370 $3K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 175 $3K
90697 <1% 686 $3K
71250 <1% 50 $3K
77080 <1% 197 $3K
86140 <1% 2,327 $3K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 265 $3K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 34 $3K
90681 <1% 966 $2K
73030 <1% 258 $2K
95806 <1% 53 $2K
99460 <1% 44 $2K
82950 <1% 416 $2K
74178 <1% 14 $2K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 519 $2K
72141 <1% 20 $2K
90633 <1% 1,479 $2K
84439 <1% 404 $2K
98960 <1% 145 $2K
85027 <1% 1,209 $2K
85652 <1% 2,083 $2K
73610 <1% 111 $2K
90715 <1% 59 $2K
99406 <1% 309 $2K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 18 $2K
0001A <1% 47 $1K
87210 <1% 303 $1K
98966 <1% 56 $1K
99382 <1% 14 $1K
76818 <1% 22 $1K
90680 <1% 1,468 $1K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 12 $1K
J1040 Injection, methylprednisolone acetate, 80 mg <1% 160 $882.83
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 42 $813.34
99217 <1% 32 $796.03
81002 <1% 338 $778.28
84702 <1% 52 $693.90
99305 <1% 110 $656.52
90656 <1% 767 $641.81
90716 <1% 336 $585.23
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes <1% 28 $552.55
99441 <1% 35 $525.41
71045 Radiologic examination, chest; single view <1% 41 $485.67
99490 Ccm add 20min <1% 606 $478.78
90734 <1% 143 $452.32
81001 <1% 242 $431.33
0002A <1% 14 $391.06
11721 <1% 79 $379.26
81003 <1% 217 $357.30
84460 <1% 408 $309.07
90619 <1% 15 $300.93
72072 <1% 16 $283.78
99316 <1% 28 $281.60
D1206 Topical application of fluoride varnish <1% 14 $273.00
90661 <1% 227 $265.68
90698 <1% 1,181 $260.34
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml <1% 1,582 $258.50
90700 <1% 117 $253.50
90707 <1% 302 $239.92
73502 <1% 19 $237.78
94726 <1% 14 $235.92
90648 <1% 2,600 $234.39
90461 <1% 80 $232.81
99442 <1% 18 $221.70
94729 <1% 14 $218.67
73130 <1% 15 $205.25
1160F <1% 1,165 $190.00
83550 <1% 42 $184.67
82565 <1% 233 $176.73
73120 <1% 18 $174.62
83540 <1% 59 $171.32
1159F <1% 1,164 $170.00
D0190 <1% 14 $168.00
82607 <1% 51 $157.50
92558 <1% 55 $156.47
82570 <1% 89 $150.06
72040 <1% 16 $144.13
84450 <1% 169 $135.53
73562 <1% 13 $130.38
G0008 Administration of influenza virus vaccine <1% 265 $122.84
0501F <1% 537 $110.00
82043 <1% 90 $101.44
99348 <1% 27 $63.35
99497 <1% 21 $60.48
80047 <1% 14 $54.11
84156 <1% 18 $51.26
82728 <1% 18 $33.86
3074F <1% 450 $20.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg <1% 19 $12.45
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 71 $4.21
99499 0% 45,849 $0.00
3078F 0% 439 $0.00
90685 0% 122 $0.00
99053 0% 357 $0.00
91300 0% 95 $0.00
3288F 0% 14 $0.00
90682 0% 12 $0.00
90687 0% 38 $0.00
90662 0% 19 $0.00
3292F 0% 2,519 $0.00
3294F 0% 180 $0.00
90744 0% 409 $0.00
3079F 0% 175 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 0% 581 $0.00
3075F 0% 124 $0.00
99024 0% 31 $0.00
90688 0% 44 $0.00
1111F 0% 21 $0.00
3048F 0% 13 $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 officialCLEAR, AMANDA (DIRECTOR OF QUALITY)