Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $1.48M by Medicaid between Jan 2018 and Sep 2024, across 48 billing codes. Its largest line is 99284, emergency room visit (serious) — 54% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
ERWIN, TN 37650
ERWIN, TN 37650
33aNPI1013346550assigned 11/05/2013
33bProvider typeGeneral Acute Care Hospital
28Total paid$1.48M
24GClaims40,143
24DCodes billed48
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other General Acute Care Hospital providers in Tennessee
Rank by total paid#59 of 71
Median peer was paid$6.96M
This provider vs. median0.2×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official HILTON, SHANE controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 6,709 | $190K | |
| 2019 | 7,709 | $193K | |
| 2020 | 3,872 | $132K | |
| 2021 | 4,654 | $190K | |
| 2022 | 6,894 | $299K | |
| 2023 | 6,935 | $284K | |
| 2024incomplete | 3,370 | $197K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 54% | 6,899 | 5,790 | $796K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 17% | 2,897 | 2,530 | $255K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 15% | 2,184 | 1,671 | $218K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 5.8% | 960 | 816 | $87K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 2.0% | 1,784 | 1,406 | $30K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.6% | 7,199 | 5,363 | $24K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 187 | 172 | $14K |
| 80053 | Comprehensive metabolic panel | <1% | 5,248 | 4,004 | $13K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 739 | 557 | $10K |
| 84484 | <1% | 952 | 596 | $4K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 1,494 | 1,033 | $4K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 539 | 391 | $4K |
36 more codes
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 190 | $3K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 604 | $3K |
| 83735 | <1% | 1,055 | $3K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 136 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 319 | $2K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 56 | $2K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 42 | $1K |
| 71045 | Radiologic examination, chest; single view | <1% | 504 | $1K |
| 81001 | <1% | 1,625 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,103 | $993.64 |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 239 | $845.61 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 344 | $642.46 |
| 83690 | <1% | 172 | $566.85 | |
| 87081 | <1% | 101 | $521.87 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 145 | $512.76 |
| 87400 | <1% | 179 | $362.93 | |
| 87077 | <1% | 102 | $350.26 | |
| 83605 | <1% | 86 | $345.41 | |
| 85610 | <1% | 366 | $253.30 | |
| 85730 | <1% | 174 | $244.18 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 62 | $231.12 |
| 81025 | <1% | 38 | $130.08 | |
| 83874 | <1% | 48 | $117.65 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 445 | $81.12 |
| 87070 | <1% | 14 | $67.95 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 12 | $59.50 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 348 | $53.70 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 20 | $52.82 |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 15 | $50.61 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 60 | $50.34 |
| 83880 | <1% | 13 | $44.42 | |
| 81003 | <1% | 83 | $36.40 | |
| 85027 | <1% | 14 | $34.04 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 16 | $25.38 |
| A9270 | Non-covered item or service | 0% | 312 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 19 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialHILTON, SHANE (EVP/CFO)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.