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    OpenPayerNPI Medicare & MedicaidEast Tennessee Children's Hospital Association, In…
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    East Tennessee Children's Hospital Association, Inc. — Billing Profile & Reimbursement Data

    NPI 1194921874 · Knoxville, TN · Pediatric Pulmonology Physician

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    East Tennessee Children's Hospital Association, Inc. is a pediatric pulmonology physician provider located in Knoxville, Tennessee. This profile covers 0 Medicare and 26 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
    OrganizationEast Tennessee Children's Hospital Association, Inc.
    Address2018 Clinch Avenue, South Tower 1st Floor
    CityKnoxville
    StateTN
    ZIP37916
    TaxonomyPediatric Pulmonology Physician
    NPI EnumeratedJune 21, 2007

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

    Payer SourceTotal Paid
    Medicaid$2.6M
    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.

    26 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…13,290$70$957.1K
    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…12,080$50$592.1K
    94060The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…8,770$30$280.5K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…2,130$100$221.2K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…2,560$60$163.7K
    99204The provider sees a new 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 provider…820$110$92.4K
    94010The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…5,990$20$89.8K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…1,370$50$64.2K
    99234The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…200$130$25.2K
    99243The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…200$80$17.1K

    Showing 1–10 of 26

    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

    26 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    90378Immunoglobulin is a very complex protein that is produced by certain cells in the body to protect it from various types of infections and produce passive immunity. RSV–IgIM (respiratory syncytial…21060$1,560$642.8K
    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…2423,760610$40$202.3K
    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…3444,050620$30$183.9K
    99204The provider sees a new 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 provider…1831,080120$80$90.7K
    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…488620740$20$88.8K
    99244The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…4890100$140$77.4K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…80550290$30$77K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…258840440$20$73K
    99243The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…277090$90$59.9K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…60660190$60$53.3K

    Showing 1–10 of 26

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with East Tennessee Children's Hospital Association, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    East Tennessee Children's Hospital Association, Inc.TNChildren's Hospital$0$88.6M
    East Tennessee Children's Primary Care Center, Inc.TNPediatrics Physician$0$31.4M
    East Tennessee Children's Hospital Association, IncTNDurable Medical Equipment & Medical Supplies$0$20.3M
    Dba: Dolly Parton Children's Hospital CardiologyTNPediatric Cardiology Physician$0$3.5M
    East Tennessee Children's Hospital Association, Inc.TNPediatric Anesthesiology Physician$0$2.5M
    East Tennessee Children's Primary Care Center, Inc.TNPediatrics Physician$0$2.4M
    Larry PattersonTNOphthalmology Physician$929.6K$0
    Michael MooreTNCertified Registered Nurse Anesthetist$22.4K$0
    Catherine RamseyMSCertified Registered Nurse Anesthetist$17.1K$0

    Nearby Providers

    Other providers in the same ZIP code as East Tennessee Children's Hospital Association, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Fort Sanders Perinatal CenterTNMaternal & Fetal Medicine Physician$0$46.5M
    Fort Sanders Regional Medical CenterTNGeneral Acute Care Hospital$0$26.8M
    Vista Radiology, PC.TNDiagnostic Radiology Physician$0$10.7M
    Allergy & Asthma Affiliates, PCTNAllergy & Immunology Physician$0$7M
    Knoxville Pediatric Associates, P.C.TNPediatrics Physician$0$6.1M
    American Anesthesiology Of Tennessee, P.C.TNCertified Registered Nurse Anesthetist$0$4.9M
    Knoxville Pediatric Ophthalmology, PLLCTNOphthalmology Physician$0$3.3M
    Innovative Pathology Services PLLCTNAnatomic Pathology & Clinical Pathology Physician$0$2.5M
    East Tennessee Pediatric Cardiology, P.C.TNPediatric Cardiology Physician$0$2.5M
    Deena CantrillTNFamily Nurse Practitioner$609.8K$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
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Tennessee Distribution
    East Tennessee Children's Hospital Association, Inc. — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee