Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Tennessee for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Tennessee only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Tennessee (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

East Tennessee Recovery, PLLC (NPI 1114462215)

Field	Value
Entity Type	Organization
Organization	East Tennessee Recovery, PLLC
Address	2408 Susannah St Ste 1
City	Johnson City
State	TN
ZIP	37601
Taxonomy	Addiction Medicine (Internal Medicine) Physician
NPI Enumerated	December 27, 2016

Payer Source	Total Paid
Medicaid	$28.3M
Medicare	$0

Key Findings

This provider is effectively single‑payer at scale: there is no Medicare billing on file while lifetime Medicaid revenue is $28.3M, indicating the organization’s commercial footprint (or Medicare participation) is either minimal or absent and its operations are concentrated in the Medicaid population. The NPI has been enumerated since 2016-12-27 (~10 years ago), so this Medicaid-focused revenue base is built over an established, multi‑year presence in-state.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicaid codes (G9012, G0483, 99214) account for 59.8% of the provider’s total Medicaid revenue. Specifically, G9012 generates $6.6M (25.1%), G0483 generates $4.9M (18.6%), and 99214 generates $4.2M (16.1%), making these three codes the primary revenue drivers for the practice.

The code mix and descriptions point to an addiction‑treatment centered operation with high-intensity monitoring and longitudinal outpatient management. High volumes in case management and comprehensive medication services (G9012, H2010), ambulatory detox and medical somatic services (H0014, H0016), plus frequent E/M visits (99214) suggest integrated medication and psychosocial treatment for substance use disorders rather than episodic general internal medicine care.

This provider is a dominant in‑state performer for certain service lines: G9012 (37.1K claims, $178 avg paid/claim, $6.6M revenue) ranks #1 of 14 providers in-state (100th percentile; notably above typical state volume for this code), signaling market leadership in the specified case management service. Likewise, 90853 group therapy activity (38.6K claims, $12 avg paid/claim, $463K revenue) ranks #1 of 106 providers in-state (100th percentile; extreme outlier), reinforcing that group‑based modalities are delivered at an unusually large scale here.

High utilization of office E/M visits supports a high-volume ambulatory practice model: 99214 shows 79.8K claims, $53 avg paid/claim and $4.2M revenue, and ranks #34 of 3759 providers in-state (99th percentile; notably above typical state volume for this code). This placement indicates the provider treats very large numbers of established patients at moderate‑complexity visit levels relative to in‑state peers.

Lab and drug‑testing services are an operational focus, with especially large volumes of both definitive and presumptive testing. G0483 appears at 44.2K claims ($111 avg, $4.9M revenue) and 80307 at 66.1K claims ($38 avg, $2.5M revenue); G0483 ranks #2 of 55 providers in-state (98th percentile; typical, unremarkable volume for this code) while other definitive testing codes (G0481, G0480) also contribute, indicating a substantial, systematic testing program tied to medication monitoring and compliance.

Several ancillary behavioral‑health codes are notable outliers, highlighting a broad service mix beyond one‑to‑one visits. Tobacco‑cessation counseling 99406 is 16.3K claims ($6 avg, $97.7K revenue) and ranks #2 of 320 providers in-state (100th percentile; extreme outlier), and H0005 group counseling (8.4K claims, $27 avg, $226.1K revenue) ranks #1 of 7 providers in-state (100th percentile; typical, unremarkable volume). These patterns point to an organization delivering high volumes of group and brief‑intervention services alongside medication and testing.

Beyond the top three drivers, medication management and detox codes contribute meaningful revenue and reflect clinical complexity: H0016 (medical/somatic services) reports $1.3M (4.8% of Medicaid revenue) and H2010 (comprehensive medication services) reports $1M (3.9% of Medicaid revenue), with H2010 ranking #4 of 66 providers in-state (95th percentile; notably above typical state volume). Together with the practice’s tenure (NPI enumerated 2016-12-27, ~10 years ago), these figures describe an established, Medicaid‑centric addiction medicine provider that pairs high testing throughput with structured medication and group treatment services.

Medicaid: Complete Services Breakdown

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

79 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9012	Other specified case management service not elsewhere classified	37,080	$180	$6.6M
G0483	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…	44,220	$110	$4.9M
99214	The 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…	79,850	$50	$4.2M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	66,130	$40	$2.5M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	42,250	$40	$1.5M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	8,070	$160	$1.3M
H2010	Comprehensive medication services, per 15 minutes	7,240	$140	$1M
H0014	Alcohol and/or drug services; ambulatory detoxification	5,320	$150	$803.5K
99213	The 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…	15,100	$40	$619.1K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	38,580	$10	$463K

Showing 1–10 of 79

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

East Tennessee Recovery, PLLC — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

79 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	22	20	1,370	$240	$5.5M
G0482	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…	31	60	430	$50	$1M
H0032	Mental health service plan development by non-physician	4	10	130	$260	$998.8K
G9012	Other specified case management service not elsewhere classified	1	10	270	$190	$869.8K
G0483	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…	2	60	840	$60	$705.4K
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	15	130	620	$200	$655.5K
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…	5	70	180	$60	$589.9K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	114	360	350	$50	$414.4K
H0014	Alcohol and/or drug services; ambulatory detoxification	7	80	250	$250	$405.4K
H0038	Self‑help/peer services, per 15 minutes	14	30	1,450	$40	$310.3K

Showing 1–10 of 79

Related Providers

Other providers that share a Tax Identification Number (TIN) with East Tennessee Recovery, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
National Addiction Specialists LLC	TN	Addiction Medicine (Internal Medicine) Physician	$0	$6.3M
Jason Della Vecchia	TN	Addiction Medicine (Internal Medicine) Physician	$108.8K	$623.2K
Alicia Emery	NC	Family Nurse Practitioner	$117.2K	$0
Tina Evans	KY	Psychiatric/Mental Health Nurse Practitioner	$41.2K	$0
Rebecca Greenway	TN	Clinical Social Worker	$8.3K	$0

Nearby Providers

Other providers in the same ZIP code as East Tennessee Recovery, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aeroflow Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$40.9M
Talkback, Inc.	TN	Speech-Language Pathologist	$0	$8.2M
Mini Miracles Pediatric Therapy, PLLC	TN	Early Intervention Provider Agency	$0	$7.2M
Washington County-johnson City Emergency Medical Services Inc	TN	Land Ambulance	$1.6M	$5.3M
Lincare Inc	TN	Durable Medical Equipment & Medical Supplies	$0	$4.6M
Dragonfly Medical And Behavioral Health Professsional Corporation	TN	Addiction Medicine (Family Medicine) Physician	$0	$4.5M
Fairview Therapy	TN	Early Intervention Provider Agency	$0	$2.8M
Dawn Of Hope, Inc	TN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$2.8M
Watauga Orthopaedics Plc	TN	Orthopaedic Surgery Physician	$0	$2.5M
Envision Inc	TN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$2.5M

East Tennessee Recovery, PLLC — Billing Profile & Reimbursement Data

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East Tennessee Recovery, PLLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References