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    OpenPayerNPI Medicare & MedicaidMountain States Health Alliance
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    Mountain States Health Alliance — Billing Profile & Reimbursement Data

    NPI 1891801734 · Elizabethton, TN · General Acute Care Hospital

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    Mountain States Health Alliance is a general acute care hospital provider located in Elizabethton, Tennessee. This profile covers 0 Medicare and 83 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
    OrganizationMountain States Health Alliance
    Address1501 W Elk Ave
    CityElizabethton
    StateTN
    ZIP37643
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedAugust 22, 2006

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

    Payer SourceTotal Paid
    Medicaid$7.2M
    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.

    83 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99284The 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.16,660$180$2.9M
    99285The 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.9,780$200$2M
    99283The 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.11,830$120$1.4M
    0241UN/A2,290$90$194.8K
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.7,910$20$174K
    99282The 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.610$90$54.7K
    85025A 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…18,110$1$54.3K
    U0003Infectious 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…840$60$53.6K
    84484The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…6,260$10$43.8K
    74177The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.730$60$42.1K

    Showing 1–10 of 83

    • More pages

    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

    83 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient61601,340$50$1.1M
    99284The 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.71630510$120$1.1M
    99283The 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.92610570$110$884.4K
    99285The 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.58570640$100$637.8K
    0202UThis is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…15201,060$210$535.6K
    U0003Infectious 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…33100400$60$524.7K
    G0378Hospital observation service, per hour38100410$210$264K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.145240840$20$259.2K
    99282The 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.88180480$90$245.5K
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.431203,760$30$225K

    Showing 1–10 of 83

    • More pages

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Johnston Memorial Hospital, IncVAGeneral Acute Care Hospital$0$35.9M
    Mountain States Health AllianceTNGeneral Acute Care Hospital$0$31.3M
    Mountain States Health AllianceTNGeneral Acute Care Hospital$0$15.5M
    Mountain States Health AllianceVAGeneral Acute Care Hospital$0$11.4M
    Mountain States Health AllianceVACritical Access Hospital$0$8.3M
    Mountain States Health AllianceTNGeneral Acute Care Hospital$0$8.1M
    Mountain States Health AllianceTNCritical Access Hospital$0$3M
    Charlotte TownsendVAFamily Medicine Physician$227.2K$33.9K
    Dane LeeVAFamily Medicine Physician$59.9K$88.1K
    Marta WaytTNInternal 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.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Silver Angels Of Tennessee - Carter, LLCTNIn Home Supportive Care Agency$0$19.6M
    Medical Care PLLCTNFamily Medicine Physician$0$13.1M
    Ocoee Hillview Health Center LLCTNSkilled Nursing Facility$0$11M
    Aging In Place, Inc.TNHome Health Agency$0$4.6M
    Carter County Emergency & Rescue Squad, IncTNLand Ambulance$708.3K$2.4M
    Blue Ridge Medical Management CorporationTNInternal Medicine Physician$0$2.8M
    Physical Therapy Services, P.A.TNClinic/Center$0$2.2M
    Med-trans CorporationTNAir Ambulance$353.1K$253.2K
    Alainya HareTNPodiatrist$49.4K$33.7K
    Michelle DavenportTNInternal Medicine Physician$55.8K$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
    3 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    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