Transylvania Community Hospital, INC

Transylvania Community Hospital, INC was paid $875K by Medicaid between Jan 2018 and Jan 2019, across 36 billing codes. Its largest line is 99283, emergency room visit (moderate) — 50% of everything it billed.

33Billing provider infoTRANSYLVANIA COMMUNITY HOSPITAL, INC
BREVARD, NC 28712

33aNPI1376613703assigned 11/09/2006

33bProvider typeCritical Access Hospital

28Total paid$875K

24GClaims13,801

24DCodes billed36

24AFirst – last monthJan 2018 – Jan 2019

Compared with peers

Next to other Critical Access Hospital providers in North Carolina

Rank by total paid#16 of 25

Median peer was paid$1.32M

This provider vs. median0.7×

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

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

Year	Claims	Paid
2018	12,694	$794K
2019	1,107	$81K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	50%	2,510	2,213	$437K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	32%	1,245	1,054	$278K
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	7.5%	219	174	$66K
87801	Infectious agent detection by nucleic acid; amplified probe, multiple organisms	1.4%	235	220	$12K
96374	Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance	1.1%	196	186	$9K
96375	Therapeutic injection; each additional sequential IV push	<1%	79	73	$8K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	1,297	1,198	$8K
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	<1%	599	497	$7K
80053	Comprehensive metabolic panel	<1%	957	898	$7K
J3490	Unclassified drugs	<1%	1,964	1,433	$6K
71045	Radiologic examination, chest; single view	<1%	97	96	$5K
90853	Group psychotherapy (other than of a multiple-family group)	<1%	120	12	$4K

24 more codes

99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	1,368	$4K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	184	$4K
99213	Doctor's office visit, returning patient (routine)	<1%	495	$3K
J7030	Infusion, normal saline solution , 1000 cc	<1%	216	$3K
93005	Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	<1%	113	$3K
76816	Ultrasound, pregnant uterus, real time with image documentation, follow-up	<1%	12	$1K
99282	Emergency department visit for the evaluation and management, low to moderate severity	<1%	13	$1K
81001		<1%	503	$1K
G0378	Hospital observation service, per hour	<1%	13	$943.56
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	13	$866.75
86780		<1%	57	$828.59
90834	Psychotherapy session, about 45 minutes	<1%	73	$708.04
86703		<1%	56	$703.20
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	38	$514.08
G0463	Hospital outpatient clinic visit for assessment and management of a patient	<1%	722	$467.63
36415	Collection of venous blood by venipuncture	<1%	248	$418.13
96361	Intravenous infusion, hydration; each additional hour	<1%	13	$331.02
88142		<1%	13	$302.88
83735		<1%	53	$200.40
87081		<1%	25	$179.50
J2060	Injection, lorazepam, 2 mg	<1%	13	$168.65
80061	Lipid panel	<1%	12	$98.67
83690		<1%	14	$68.64
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	16	$28.66

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 officialCARVER, LENORA (CREDENTIALS SPECIALIST)