East Tennessee Children's Hospital Primary Care Center, INC.
East Tennessee Children's Hospital Primary Care Center, INC. was paid $547K by Medicaid between Jan 2018 and Nov 2024, across 25 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 66% of everything it billed.
ALCOA, TN 37701
Next to other Family Nurse Practitioner providers in Tennessee
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 6,873 | $208K | |
| 2019 | 147 | $10K | |
| 2020 | 606 | $25K | |
| 2021 | 998 | $69K | |
| 2022 | 1,266 | $81K | |
| 2023 | 1,627 | $92K | |
| 2024incomplete | 1,322 | $62K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 66% | 5,891 | 5,234 | $359K |
| 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 | 19% | 1,548 | 1,389 | $103K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.9% | 825 | 737 | $27K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.1% | 129 | 115 | $12K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.9% | 143 | 132 | $10K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.3% | 602 | 540 | $7K |
| 92551 | 1.0% | 518 | 467 | $5K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 60 | 56 | $4K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 193 | 155 | $4K |
| 99177 | <1% | 539 | 478 | $3K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 351 | 307 | $3K |
| 96127 | <1% | 439 | 379 | $3K |
13 more codes
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 50 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 168 | $2K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 102 | $2K |
| 36416 | <1% | 488 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 104 | $971.25 |
| 87081 | <1% | 353 | $205.19 | |
| 82465 | <1% | 13 | $7.32 | |
| 90686 | 0% | 181 | $0.00 | |
| 90688 | 0% | 49 | $0.00 | |
| 90716 | 0% | 12 | $0.00 | |
| 90670 | 0% | 40 | $0.00 | |
| 90633 | 0% | 29 | $0.00 | |
| 90707 | 0% | 12 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.