East Tennessee Children's Hospital Association INC.
East Tennessee Children's Hospital Association INC. was paid $1.03M by Medicaid between Jan 2018 and Dec 2024, across 14 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 43% 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 | 3,140 | $131K | |
| 2019 | 4,242 | $183K | |
| 2020 | 3,540 | $156K | |
| 2021 | 3,798 | $162K | |
| 2022 | 2,132 | $143K | |
| 2023 | 2,686 | $154K | |
| 2024incomplete | 1,003 | $102K |
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 | 43% | 10,716 | 9,496 | $442K |
| 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 | 31% | 4,959 | 4,179 | $319K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 6.7% | 671 | 626 | $69K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 5.4% | 1,789 | 1,676 | $56K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.1% | 586 | 524 | $43K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 2.5% | 12 | 12 | $26K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 2.3% | 902 | 245 | $24K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.4% | 330 | 114 | $14K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.1% | 140 | 116 | $12K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.0% | 116 | 107 | $10K |
| 64642 | <1% | 115 | 105 | $9K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 143 | 129 | $4K |
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.