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.

Mountain States Health Alliance (NPI 1497859789)

Field	Value
Entity Type	Organization
Organization	Mountain States Health Alliance
Address	1901 S Shady St
City	Mountain City
State	TN
ZIP	37683
Taxonomy	Critical Access Hospital
NPI Enumerated	September 8, 2006

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	9,260	$160	$1.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	7,720	$90	$671.9K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,210	$190	$415.7K
0241U	N/A	2,890	$80	$225.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	5,510	$10	$38.6K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	4,540	$10	$27.3K
87651	The 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.	660	$40	$24.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	1,220	$20	$20.8K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,380	$10	$16.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	340	$40	$15K

Showing 1–10 of 49

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

Mountain States Health Alliance — 0 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

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	106	630	510	$120	$1.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	123	610	570	$110	$884.4K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	128	570	640	$100	$637.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	95	100	400	$60	$524.7K
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.	170	240	840	$20	$259.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	104	180	480	$90	$245.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	85	120	3,760	$30	$225K
0241U	N/A	17	70	870	$90	$197.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	219	240	510	$50	$125.9K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	227	230	460	$20	$83K

Showing 1–10 of 49

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mountain States Health Alliance, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Johnston Memorial Hospital, Inc	VA	General Acute Care Hospital	$0	$35.9M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$31.3M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$15.5M
Mountain States Health Alliance	VA	General Acute Care Hospital	$0	$11.4M
Mountain States Health Alliance	VA	Critical Access Hospital	$0	$8.3M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$8.1M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$7.2M
Charlotte Townsend	VA	Family Medicine Physician	$227.2K	$33.9K
Dane Lee	VA	Family Medicine Physician	$59.9K	$88.1K
Marta Wayt	TN	Internal Medicine Physician	$118K	$0

Nearby Providers

Other providers in the same ZIP code as Mountain States Health Alliance, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Keystone Continuum, LLC	TN	Psychiatric Residential Treatment Facility	$0	$123.7M
Bethany Rock	TN	Family Nurse Practitioner	$103.6K	$0
Daniel Jones	TN	Physician Assistant	$32.3K	$0
Dereck Campbell	TN	Physician Assistant	$31.9K	$0

Mountain States Health Alliance — Billing Profile & Reimbursement Data

Sign up for Mountain States Health Alliance — Billing Profile & Reimbursement Data policy alerts

Mountain States Health Alliance — Billing Profile & Reimbursement Data

Sign up for Mountain States Health Alliance — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References