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 Addiction Specialists (NPI 1770080632)

Field	Value
Entity Type	Organization
Organization	East Tennessee Addiction Specialists
Address	111 Station Dr Bldg 3
City	Maryville
State	TN
ZIP	37804
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	April 9, 2018

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	14,470	$210	$3M
H0033	Oral medication administration, direct observation	10,780	$160	$1.7M
H0014	Alcohol and/or drug services; ambulatory detoxification	3,700	$270	$1M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	3,190	$110	$360K
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…	16,870	$10	$101.2K
H2010	Comprehensive medication services, per 15 minutes	840	$70	$60.2K
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…	2,080	$30	$56.2K
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…	1,280	$30	$38.3K
H0049	Alcohol and/or drug screening	1,470	$20	$30.9K
G2087	Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month	1,840	$10	$16.5K

Showing 1–10 of 17

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 Addiction Specialists — 3 of 17 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	11	20	3,220	$130	$2.9M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	32	30	3,390	$90	$1.3M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	7	130	620	$200	$655.5K
H0014	Alcohol and/or drug services; ambulatory detoxification	13	80	250	$250	$405.4K
H0033	Oral medication administration, direct observation	5	100	340	$150	$306.9K
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…	69	300	480	$30	$221.2K
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…	1,374	3,760	610	$40	$202.3K
H2010	Comprehensive medication services, per 15 minutes	27	70	530	$130	$187.7K
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…	2,964	4,050	620	$30	$183.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	183	200	130	$60	$86.5K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brian Pratt	GA	Family Medicine Physician	$205.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
App Of Tennessee Ed, PLLC	TN	Emergency Medicine Physician	$0	$30.3M
Prisma Health - Blount Memorial Hospital Inc.	TN	General Acute Care Hospital	$0	$14.8M
Speech Pathology Services Of East Tennessee LLC	TN	Rehabilitation Clinic/Center	$0	$9.3M
East Tennessee Oral & Maxillofacial Surgery, PC	TN	Oral and Maxillofacial Surgery (Dentist)	$0	$7.1M
Open Hearts Open Arms	TN	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$4.8M
Foothills Pediatric Dentristry, P.C.	TN	Pediatric Dentistry	$0	$2.2M
Maryville Asc	TN	Ambulatory Surgical Clinic/Center	$350.4K	$141.2K
Molecular Pathology Laboratory Network Inc	TN	Clinical Medical Laboratory	$369.4K	$60.8K
Donna Brantley	TN	Family Nurse Practitioner	$263.1K	$0
Robert Ivy	TN	Orthopaedic Hand Surgery Physician	$231.7K	$0

East Tennessee Addiction Specialists — Billing Profile & Reimbursement Data

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East Tennessee Addiction Specialists — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References