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 North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Smoky Mountain Center For Mh/dd/sas (NPI 1588903322)

Field	Value
Entity Type	Organization
Organization	Smoky Mountain Center For Mh/dd/sas
Address	44 Bonnie Ln
City	Sylva
State	NC
ZIP	28779
Taxonomy	Health Maintenance Organization
NPI Enumerated	February 13, 2013

Payer Source	Total Paid
Medicaid	$51.5M
Medicare	$0

Key Findings

This provider reports $51.5M in lifetime Medicaid revenue and has no Medicare billing on file, making its public payer footprint effectively single-payer Medicaid rather than a mixed Medicare/Medicaid operation. The absence of Medicare claims limits cross-payer comparisons and indicates Medicaid is the primary revenue source to evaluate for financial and utilization assessment.

All Medicaid revenue is driven by a single code: T1017 is reported with 185.1K claims, a $278 avg paid/claim, and $51.5M in revenue, and the precomputed top-3 codes account for 100.0% of this provider's Medicaid revenue. That concentration means the provider’s Medicaid performance and financials are essentially synonymous with its T1017 activity.

T1017 (Targeted case management, each 15 minutes) as the exclusive revenue engine indicates the organization operates predominately as a high-volume, time-based case management/service-coordination provider, likely delivering short, frequent units of care coordination or community-based behavioral health supports. The combination of unit-based billing and very high claim counts is consistent with a workforce-driven model that bills in 15-minute increments.

Revenue concentration presents material operational and payer-risk sensitivity: with the top-3 Medicaid codes accounting for 100.0% of Medicaid revenue, any policy, eligibility, or reimbursement change affecting T1017 would disproportionately impact the provider’s revenues. Analysts should treat the provider’s financial stability as tightly coupled to the policy and utilization environment for targeted case management.

Competitive standing in-state for this service is dominant: the provider ranks #1 of 216 providers in North Carolina for T1017, sits at the 100th percentile, and is labeled an extreme outlier that is far above typical state volume for this code. This positioning suggests market leadership or a large contract footprint for targeted case management within the state.

The provider’s NPI was enumerated on 2013-02-13 (~13 years ago), signaling an established operating history that aligns with the high cumulative claims volume observed for T1017. Tenure at this scale supports the interpretation that the organization has long-standing capacity and administrative systems to sustain high-frequency, time-based billing.

Operational and benchmarking implications: the dominance of T1017 implies a sizable pool of case managers and billing workflows tailored to short-interval, time-based units; payers and analysts benchmarking utilization should treat this entity as a specialized targeted case management provider rather than a general behavioral-health clinic. When comparing across peers or constructing networks, analysts should explicitly account for the provider’s specialty in T1017 services and its extreme outlier status.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	185,130	$280	$51.5M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Smoky Mountain Center For Mh/dd/sas — 1 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	1	220	1,700	$150	$1.3M

Nearby Providers

Other providers in the same ZIP code as Smoky Mountain Center For Mh/dd/sas, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dlp Western Carolina Physician Practices LLC	NC	Internal Medicine Physician	$0	$14M
Meridian Behavioral Health Services, Inc.	NC	Community/Behavioral Health Agency	$0	$9.7M
Dlp Harris Regional Hospital LLC	NC	General Acute Care Hospital	$0	$8.3M
Skyland House, LLC	NC	Adult Care Home Facility	$0	$7.2M
John Buenting	NC	Otolaryngology Physician	$325.9K	$0
Shawn Kosnik	NC	Otolaryngology Physician	$316.8K	$0
Ofelia Balta	NC	Internal Medicine Physician	$270.2K	$0
Roy Gallinger	NC	Family Medicine Physician	$259K	$0
Clifford Mault	NC	Internal Medicine Physician	$97.8K	$116.3K
Leslie Norris	NC	Family Nurse Practitioner	$190.2K	$0

Smoky Mountain Center For Mh/dd/sas — Billing Profile & Reimbursement Data

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Smoky Mountain Center For Mh/dd/sas — Billing Profile & Reimbursement Data

Sign up for Smoky Mountain Center For Mh/dd/sas — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References