East Tennessee Children's Hospital Association INC.
East Tennessee Children's Hospital Association INC. was paid $990K by Medicaid between Jan 2018 and Dec 2024, across 9 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 56% of everything it billed.
KNOXVILLE, TN 37916
Next to other Pediatrics Physician 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 | 1,185 | $65K | |
| 2019 | 1,149 | $82K | |
| 2020 | 1,232 | $80K | |
| 2021 | 3,447 | $226K | |
| 2022 | 2,324 | $189K | |
| 2023 | 2,299 | $184K | |
| 2024incomplete | 2,036 | $163K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 56% | 5,928 | 3,503 | $555K |
| 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 | 27% | 3,703 | 2,806 | $272K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.2% | 1,839 | 1,337 | $82K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 4.8% | 1,053 | 140 | $48K |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | 2.1% | 861 | 443 | $21K |
| 99417 | Prolong home eval add 15m | <1% | 192 | 113 | $6K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 28 | 28 | $5K |
| 99205 | Prolong outpt/office vis | <1% | 15 | 13 | $2K |
| 99243 | <1% | 53 | 27 | $580.71 |
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.