Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

METRO KNOXVILLE HMA LLC

NPI: 1043292899 · POWELL, TN 37849 · General Acute Care Hospital · NPI assigned 11/17/2005

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LALOR, PAULA controls 20+ related entities in our dataset. Read more

$28.70M
Total Medicaid Paid
526,481
Total Claims
434,838
Beneficiaries
138
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLALOR, PAULA (DIRECTOR/DELEGATED OFFICIAL)
NPI Enumeration Date11/17/2005

Related Entities

Other providers sharing the same authorized official: LALOR, PAULA

ProviderCityStateTotal Paid
NORTHWEST HOSPITAL LLC TUCSON AZ $47.81M
ROSWELL HOSPITAL CORPORATION ROSWELL NM $41.27M
WESLEY HEALTH SYSTEM LLC HATTIESBURG MS $37.82M
BULLHEAD CITY HOSPITAL CORPORATION BULLHEAD CITY AZ $28.54M
IOM HEALTH SYSTEM LP FORT WAYNE IN $27.50M
ST. JOSEPH HEALTH SYSTEM, LLC FORT WAYNE IN $25.43M
LAREDO TEXAS HOSPITAL COMPANY LP LAREDO TX $19.46M
OAK HILL HOSPITAL CORPORATION OAK HILL WV $18.77M
COCKE COUNTY HMA, LLC NEWPORT TN $18.34M
CLEVELAND TENNESSEE HOSPITAL COMPANY LLC CLEVELAND TN $16.31M
JEFFERSON COUNTY HMA LLC JEFFERSON CITY TN $14.31M
NORTHWEST ARKANSAS HOSPITALS, LLC SPRINGDALE AR $11.46M
PETERSBURG HOSPITAL COMPANY LLC PETERSBURG VA $11.20M
CAMPBELL COUNTY HMA, LLC LAFOLLETTE TN $10.07M
WARSAW HEALTH SYSTEM LLC WARSAW IN $9.95M
LONGVIEW MEDICAL CENTER LP LONGVIEW TX $9.29M
MOBERLY HOSPITAL COMPANY LLC MOBERLY MO $8.61M
CRESTVIEW HOSPITAL COMPANY, LLC CRESTVIEW FL $8.15M
KIRKSVILLE MISSOURI HOSPITAL COMPANY, LLC KIRKSVILLE MO $7.98M
VICTORIA OF TEXAS LP VICTORIA TX $7.74M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 128,295 $6.92M
2019 88,142 $4.28M
2020 75,131 $3.33M
2021 72,540 $4.33M
2022 57,370 $3.74M
2023 60,476 $3.49M
2024 44,527 $2.59M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 43,654 37,066 $11.01M
99283 Emergency department visit for the evaluation and management, moderate severity 48,524 42,722 $9.55M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 7,363 5,617 $2.19M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 6,275 5,068 $1.75M
45380 Colonoscopy, flexible; with biopsy, single or multiple 1,845 1,410 $628K
99282 Emergency department visit for the evaluation and management, low to moderate severity 4,502 4,114 $557K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 4,700 1,581 $382K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 21,052 17,898 $283K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 57,840 47,481 $165K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 437 370 $160K
96375 Therapeutic injection; each additional sequential IV push 10,094 8,450 $154K
87428 3,232 2,856 $131K
80053 Comprehensive metabolic panel 52,250 43,585 $126K
93458 284 202 $117K
95811 779 610 $114K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 349 273 $102K
62323 603 518 $99K
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r 1,901 1,686 $94K
95810 Polysomnography; sleep staging with 4 or more additional parameters 548 455 $94K
G0378 Hospital observation service, per hour 875 642 $91K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 6,085 5,232 $79K
84484 10,862 7,533 $71K
36415 Collection of venous blood by venipuncture 58,192 46,332 $51K
96361 Intravenous infusion, hydration; each additional hour 8,382 7,125 $49K
J2405 Injection, ondansetron hydrochloride, per 1 mg 6,961 5,860 $47K
59025 Fetal non-stress test 965 674 $46K
99281 Emergency department visit for the evaluation and management, self-limited or minor 435 400 $40K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 13,195 10,249 $35K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2,336 1,989 $35K
71045 Radiologic examination, chest; single view 12,803 10,566 $31K
43248 99 80 $28K
74177 Computed tomography, abdomen and pelvis; with contrast material 565 492 $28K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 6,462 5,598 $27K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 2,933 2,466 $27K
83690 9,424 8,010 $27K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1,128 1,014 $25K
76700 Ultrasound, abdominal, real time with image documentation; complete 585 480 $21K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,437 2,296 $21K
70450 Computed tomography, head or brain; without contrast material 846 698 $19K
81025 10,096 9,131 $19K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 631 566 $17K
74176 Computed tomography, abdomen and pelvis; without contrast material 684 564 $16K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 5,437 4,435 $14K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 3,526 3,243 $12K
77067 Screening mammography, bilateral, including computer-aided detection 353 332 $12K
81001 19,108 16,501 $11K
80061 Lipid panel 3,009 2,742 $10K
87081 2,875 2,642 $7K
84443 Thyroid stimulating hormone (TSH) 1,801 1,643 $6K
71046 Radiologic examination, chest; 2 views 1,633 1,378 $6K
76770 163 127 $5K
45384 16 14 $5K
74018 358 307 $5K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 44 38 $5K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 319 251 $4K
87086 Culture, bacterial; quantitative colony count, urine 1,086 945 $4K
84702 374 331 $4K
80048 Basic metabolic panel (calcium, ionized) 2,679 2,048 $3K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 202 168 $3K
83735 1,152 873 $3K
0002A 97 75 $2K
83036 Hemoglobin; glycosylated (A1C) 1,906 1,740 $2K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 183 166 $2K
64493 15 12 $2K
85610 1,732 1,348 $2K
74178 17 12 $1K
76830 Ultrasound, transvaginal 24 24 $1K
85730 873 672 $1K
95806 14 14 $1K
0001A 38 31 $1K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 512 417 $952.40
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 65 59 $868.82
83970 32 28 $788.03
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 throughput technologies as described by cms-2020-01-r 25 24 $600.00
J7030 Infusion, normal saline solution , 1000 cc 4,833 4,187 $568.41
81003 1,374 1,197 $525.45
83880 131 102 $417.32
85027 756 585 $399.30
J2250 Injection, midazolam hydrochloride, per 1 mg 1,107 828 $377.77
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 26 24 $364.56
83605 93 65 $358.70
82657 698 576 $314.88
11045 25 12 $307.53
82248 369 334 $292.42
82550 143 113 $277.76
82077 58 52 $272.95
J3010 Injection, fentanyl citrate, 0.1 mg 2,034 1,557 $231.55
88305 Level IV - Surgical pathology, gross and microscopic examination 5,702 4,578 $199.64
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 149 108 $194.60
84460 265 250 $161.28
J1100 Injection, dexamethasone sodium phosphate, 1 mg 215 177 $153.06
84144 17 13 $151.96
84450 173 162 $135.36
94760 252 83 $134.54
82728 29 27 $118.72
82962 3,082 1,601 $107.59
83516 48 26 $106.93
77063 Screening digital breast tomosynthesis, bilateral 12 12 $103.68
J1170 Injection, hydromorphone, up to 4 mg 277 204 $97.62
84100 104 56 $96.12
88342 1,958 1,594 $90.40
J2704 Injection, propofol, 10 mg 14,127 10,865 $80.49
83540 41 39 $77.44
83550 29 27 $76.32
86140 47 41 $75.58
87070 232 152 $75.00
96376 53 29 $71.22
86850 13 12 $70.37
J1644 Injection, heparin sodium, per 1000 units 468 330 $64.20
J1885 Injection, ketorolac tromethamine, per 15 mg 8,160 7,076 $61.59
81000 28 27 $53.35
84481 14 13 $46.15
80305 16 13 $40.41
J2270 Injection, morphine sulfate, up to 10 mg 78 66 $39.73
J1020 Injection, methylprednisolone acetate, 20 mg 1,040 813 $32.63
J2765 Injection, metoclopramide hcl, up to 10 mg 24 19 $29.84
82043 40 38 $25.20
84439 14 13 $24.55
82570 21 20 $16.92
80076 14 14 $4.45
91300 95 91 $0.06
C1769 Guide wire 398 325 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 260 209 $0.00
99153 Mod sedat endo service >5yrs 86 65 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 113 97 $0.00
J0690 Injection, cefazolin sodium, 500 mg 47 37 $0.00
C1889 Implantable/insertable device, not otherwise classified 34 25 $0.00
80320 14 12 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 669 495 $0.00
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 2,659 2,155 $0.00
99152 562 409 $0.00
88313 107 79 $0.00
87329 24 15 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 49 38 $0.00
87324 24 15 $0.00
87328 24 15 $0.00
J1650 Injection, enoxaparin sodium, 10 mg 22 12 $0.00
83630 24 15 $0.00