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.

Applachian Recovery Care, PLLC (NPI 1497232540)

Field	Value
Entity Type	Organization
Organization	Applachian Recovery Care, PLLC
Address	2726 W State St
City	Bristol
State	TN
ZIP	37620
Taxonomy	Addiction Medicine (Internal Medicine) Physician
NPI Enumerated	July 22, 2018

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	8,810	$240	$2.1M
H0033	Oral medication administration, direct observation	1,500	$170	$254.5K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	2,490	$10	$22.4K
H2010	Comprehensive medication services, per 15 minutes	60	$60	$3.7K

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

Applachian Recovery Care, PLLC — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	13	130	620	$200	$655.5K
H0033	Oral medication administration, direct observation	26	100	340	$150	$306.9K
H2010	Comprehensive medication services, per 15 minutes	57	70	530	$130	$187.7K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	76	460	360	$1	$8.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellmont Health System	TN	General Acute Care Hospital	$0	$27.3M
Bristol Pediatric Dentistry PLLC	TN	Pediatric Dentistry	$0	$23.4M
Ipc Pac Healthcare Services Of Tennessee PC	TN	Internal Medicine Physician	$0	$8.5M
Blue Ridge Radiology, P.C.	TN	Diagnostic Radiology Physician	$0	$4.2M
Youthcare Pediatrics	TN	Pediatrics Physician	$0	$3.1M
Ambulance Service Of Bristol Inc	TN	Ambulance	$836.3K	$1.5M
Mountain Empire Cataract & Eye Surgery Center	TN	Ambulatory Surgical Clinic/Center	$953.1K	$929.5K
The Endoscopy Center Of Bristol	TN	Ambulatory Surgical Clinic/Center	$508.4K	$181.3K
Renaissance Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$669.7K	$0
Rick Whiles	TN	Internal Medicine Physician	$634.1K	$0

Applachian Recovery Care, PLLC — Billing Profile & Reimbursement Data

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Applachian Recovery Care, PLLC — Billing Profile & Reimbursement Data

Sign up for Applachian Recovery Care, PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References