East Tennessee Children's Hospital Primary Care Center, INC.
East Tennessee Children's Hospital Primary Care Center, INC. was paid $31.61M by Medicaid between Jan 2018 and Dec 2024, across 91 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
KNOXVILLE, TN 37916
Next to other Pediatric 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 | 34,049 | $1.09M | |
| 2019 | 122,739 | $3.30M | |
| 2020 | 110,290 | $3.23M | |
| 2021 | 155,567 | $4.80M | |
| 2022 | 169,713 | $5.52M | |
| 2023 | 212,623 | $7.38M | |
| 2024incomplete | 172,837 | $6.27M |
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 | 35% | 214,784 | 177,673 | $11.06M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 12% | 82,567 | 75,179 | $3.71M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.6% | 38,344 | 35,818 | $3.02M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.7% | 38,334 | 33,635 | $2.76M |
| 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 | 8.0% | 34,986 | 30,096 | $2.53M |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 5.6% | 63,367 | 52,258 | $1.78M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.4% | 18,068 | 16,078 | $1.39M |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 3.4% | 12,738 | 11,658 | $1.08M |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 3.2% | 29,894 | 25,605 | $998K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.5% | 12,362 | 10,814 | $469K |
| 96161 | 1.3% | 24,736 | 20,932 | $419K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.0% | 3,855 | 3,484 | $327K |
79 more codes
| 92551 | 1.0% | 40,512 | $321K | |
| 99177 | <1% | 41,380 | $310K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 8,776 | $284K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 31,104 | $260K |
| 80061 | Lipid panel | <1% | 6,339 | $107K |
| 96127 | <1% | 24,742 | $106K | |
| 99381 | <1% | 1,066 | $83K | |
| 99173 | <1% | 14,479 | $79K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 6,314 | $76K |
| 36416 | <1% | 40,600 | $70K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 4,643 | $56K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,785 | $40K |
| 87807 | <1% | 2,743 | $30K | |
| 90670 | <1% | 19,188 | $25K | |
| 99460 | <1% | 418 | $19K | |
| 86738 | <1% | 1,463 | $17K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 1,410 | $17K |
| 83655 | <1% | 1,237 | $17K | |
| 81003 | <1% | 8,024 | $17K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 150 | $12K |
| 90686 | <1% | 19,618 | $11K | |
| 99383 | <1% | 112 | $10K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 411 | $8K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 105 | $7K |
| 99382 | <1% | 83 | $7K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 149 | $7K |
| 92567 | <1% | 457 | $7K | |
| 90723 | <1% | 13,689 | $6K | |
| 90680 | <1% | 12,191 | $6K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,967 | $6K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 338 | $5K |
| 90677 | <1% | 4,631 | $4K | |
| 87081 | <1% | 1,542 | $4K | |
| 90651 | <1% | 383 | $3K | |
| 88720 | <1% | 558 | $3K | |
| 54150 | <1% | 17 | $3K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 1,158 | $3K |
| 69210 | <1% | 55 | $3K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 187 | $2K |
| 90647 | <1% | 11,936 | $2K | |
| 85018 | <1% | 727 | $2K | |
| 90633 | <1% | 4,845 | $2K | |
| 0072A | <1% | 37 | $1K | |
| 90716 | <1% | 976 | $1K | |
| 82247 | <1% | 224 | $1K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 105 | $1K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 15 | $969.33 |
| 90697 | <1% | 828 | $831.35 | |
| 90707 | <1% | 981 | $766.04 | |
| 85027 | <1% | 116 | $739.09 | |
| 90656 | <1% | 1,043 | $503.52 | |
| 90620 | <1% | 18 | $498.81 | |
| 90671 | <1% | 390 | $488.18 | |
| 82465 | <1% | 233 | $404.31 | |
| 81001 | <1% | 115 | $374.08 | |
| 96380 | <1% | 13 | $240.58 | |
| 90734 | <1% | 179 | $182.81 | |
| 90661 | <1% | 1,486 | $151.73 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 157 | $144.12 |
| 90696 | <1% | 106 | $129.65 | |
| 90674 | <1% | 913 | $117.63 | |
| 90648 | <1% | 1,242 | $102.06 | |
| 90700 | <1% | 329 | $68.12 | |
| 99051 | <1% | 14 | $51.45 | |
| 82947 | <1% | 12 | $47.45 | |
| 90688 | <1% | 153 | $20.85 | |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | <1% | 32 | $5.85 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 67 | $3.68 |
| 90710 | 0% | 71 | $0.00 | |
| 90685 | 0% | 140 | $0.00 | |
| 90681 | 0% | 119 | $0.00 | |
| 90715 | 0% | 31 | $0.00 | |
| E0445 | Oximeter device for measuring blood oxygen levels non-invasively | 0% | 65 | $0.00 |
| 90672 | 0% | 13 | $0.00 | |
| 91300 | 0% | 34 | $0.00 | |
| 3008F | 0% | 59,666 | $0.00 | |
| 91307 | 0% | 77 | $0.00 | |
| 90698 | 0% | 207 | $0.00 | |
| 90744 | 0% | 44 | $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.