Hospital
Macon County General Hospital, INC.
Macon County General Hospital, INC. was paid $3.82M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is 99283, emergency room visit (moderate) — 27% of everything it billed.
33Billing provider infoMACON COUNTY GENERAL HOSPITAL, INC.
LAFAYETTE, TN 37083
LAFAYETTE, TN 37083
33aNPI1417938846assigned 11/11/2005
33bProvider typeCritical Access Hospital
28Total paid$3.82M
24GClaims145,526
24DCodes billed80
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Critical Access Hospital providers in Tennessee
Rank by total paid#3 of 15
Median peer was paid$1.48M
This provider vs. median2.6×
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 | 18,524 | $427K | |
| 2019 | 21,507 | $495K | |
| 2020 | 17,532 | $376K | |
| 2021 | 18,246 | $521K | |
| 2022 | 23,349 | $722K | |
| 2023 | 25,866 | $686K | |
| 2024incomplete | 20,502 | $591K |
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 | 27% | 9,511 | 9,033 | $1.03M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 22% | 5,725 | 5,327 | $828K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 18% | 4,955 | 4,467 | $696K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 5.4% | 3,653 | 3,358 | $206K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.5% | 9,676 | 4,541 | $94K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 2.2% | 16,650 | 12,477 | $85K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | 1.8% | 3,569 | 3,284 | $67K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 1.6% | 6,868 | 4,753 | $61K |
| 80053 | Comprehensive metabolic panel | 1.6% | 12,427 | 11,039 | $59K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.4% | 1,694 | 1,561 | $55K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 1.2% | 1,975 | 1,793 | $45K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 1.1% | 685 | 631 | $42K |
68 more codes
| 87430 | 1.1% | 3,318 | $42K | |
| 71045 | Radiologic examination, chest; single view | 1.0% | 2,990 | $39K |
| 84484 | <1% | 4,186 | $38K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,429 | $36K |
| 83735 | <1% | 8,834 | $32K | |
| 83880 | <1% | 2,019 | $32K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 646 | $30K |
| G0378 | Hospital observation service, per hour | <1% | 217 | $28K |
| 36415 | Collection of venous blood by venipuncture | <1% | 11,447 | $21K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 168 | $21K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 1,581 | $21K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 298 | $20K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 1,343 | $19K |
| 94664 | <1% | 811 | $17K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 268 | $17K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 850 | $15K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 539 | $13K |
| 85379 | <1% | 1,915 | $12K | |
| 83874 | <1% | 1,108 | $8K | |
| 82553 | <1% | 1,901 | $8K | |
| 82550 | <1% | 1,940 | $7K | |
| 83690 | <1% | 1,169 | $7K | |
| 82150 | <1% | 1,114 | $6K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,106 | $6K |
| 81001 | <1% | 3,667 | $6K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 1,846 | $5K |
| 84703 | <1% | 461 | $4K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 222 | $4K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,438 | $4K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 13 | $3K |
| 83605 | <1% | 528 | $3K | |
| 80061 | Lipid panel | <1% | 589 | $3K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 814 | $2K |
| 84439 | <1% | 906 | $2K | |
| 87040 | <1% | 333 | $2K | |
| 82607 | <1% | 401 | $2K | |
| 82746 | <1% | 351 | $2K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 61 | $2K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 112 | $1K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 59 | $1K |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 426 | $1K |
| 87420 | <1% | 83 | $1K | |
| 97161 | <1% | 26 | $944.85 | |
| 85610 | <1% | 315 | $653.89 | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 53 | $611.39 |
| 96376 | <1% | 84 | $525.70 | |
| 86328 | <1% | 19 | $407.07 | |
| 84145 | <1% | 21 | $397.42 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 43 | $392.35 |
| 94760 | <1% | 246 | $370.81 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 74 | $330.22 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 404 | $312.10 |
| 84100 | <1% | 208 | $283.18 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 331 | $273.62 |
| 81003 | <1% | 187 | $265.50 | |
| 85730 | <1% | 70 | $240.81 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 101 | $236.30 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 256 | $202.53 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | <1% | 48 | $173.79 |
| 81025 | <1% | 17 | $154.84 | |
| 94060 | <1% | 14 | $102.12 | |
| 94729 | <1% | 14 | $98.89 | |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | <1% | 17 | $70.24 |
| 84480 | <1% | 14 | $70.16 | |
| 82728 | <1% | 14 | $50.58 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 25 | $46.43 |
| 83550 | <1% | 15 | $37.87 | |
| 83540 | <1% | 15 | $28.07 |
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 officialEVANS, ERIN (PATIENT FINANCIAL SERVICES DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Milestones Pediatric Therapy, LLC | Durango, CO | $1.08M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.