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    OpenPayerNPI Medicare & MedicaidState Of Franklin Healthcare Associates PLLC
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    State Of Franklin Healthcare Associates PLLC — Billing Profile & Reimbursement Data

    NPI 1063459410 · Johnson City, TN · Internal Medicine Physician

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    State Of Franklin Healthcare Associates PLLC is a internal medicine physician provider located in Johnson City, Tennessee. This profile covers 0 Medicare and 215 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationState Of Franklin Healthcare Associates PLLC
    Address121 Boone Ridge Dr Ste 1002
    CityJohnson City
    StateTN
    ZIP37615
    TaxonomyInternal Medicine Physician
    NPI EnumeratedJune 1, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$23.2M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    215 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…127,330$40$5.6M
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…122,230$40$4.8M
    90460In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.37,730$50$1.8M
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…19,250$70$1.3M
    99391Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…21,580$60$1.3M
    96110The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…36,120$30$1M
    87651The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.22,310$30$758.6K
    87635Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…16,140$50$742.2K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.9,830$70$649K
    76816The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.11,930$50$644K

    Showing 1–10 of 215

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Tennessee median

    215 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    80081The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens…51013,370$40$1.1M
    59400In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…5980100$1,260$405.3K
    97530The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.2713401,400$40$354.2K
    76819The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.31100670$60$342.9K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.51240840$20$259.2K
    80050The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…1540200$20$234.7K
    76816The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.11150390$60$220.9K
    90460In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.216101,220$40$206K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…193,760610$40$202.3K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…15520470$70$187K

    Showing 1–10 of 215

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with State Of Franklin Healthcare Associates PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Raymond KohneTNDiagnostic Radiology Physician$984.7K$0
    Mark WilliamsTNInternal Medicine Physician$311.7K$0
    Victor MarlarNCEndocrinology, Diabetes & Metabolism Physician$236.6K$0
    Celso EbeoTNCritical Care Medicine (Internal Medicine) Physician$125.2K$92.5K
    Candi OverholtTNInternal Medicine Physician$202.5K$0
    Beth MccurleyTNInternal Medicine Physician$183.8K$0
    Frank JohnsonTNInternal Medicine Physician$173.9K$0
    Richard RolenTNInternal Medicine Physician$170.4K$0
    Michael SnyderTNInternal Medicine Physician$148.8K$0
    Michael PearsonTNInternal Medicine Physician$145.3K$0

    Nearby Providers

    Other providers in the same ZIP code as State Of Franklin Healthcare Associates PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Frontier HealthTNMental Health Clinic/Center (Including Community Mental Health Center)$0$105.1M
    A Heavenly Sonshine Service CoTNIn Home Supportive Care Agency$0$6.3M
    Breakthrough Medical Clinic Of Tennessee IncTNSubstance Use Disorder Rehabilitation Clinic/Center$0$3.8M
    Enhanced Support ServicesTNIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$3.8M
    East Tennessee Healthcare Holdings IncTNSubstance Use Disorder Rehabilitation Clinic/Center$163.7K$3.3M
    Mountain Wings; LLCTNIn Home Supportive Care Agency$0$3M
    Matthew GrimmTNFamily Nurse Practitioner$301.9K$0
    Fay BembryTNPsychiatric/Mental Health Nurse Practitioner$207K$57.1K
    Stuart LeichtTNDermatology Physician$178.8K$710
    Tiffany YandellTNFamily Nurse Practitioner$115.4K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Tennessee Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Tennessee Distribution
    State Of Franklin Healthcare Associates PLLC — 15 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee