Monument Health Network, INC.

Monument Health Network, INC. was paid $101K by Medicaid between Jan 2018 and Nov 2024, across 6 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 76% of everything it billed.

33Billing provider infoMONUMENT HEALTH NETWORK, INC.
SPEARFISH, SD 57783

33aNPI1104205020assigned 05/26/2015

33bProvider typeOrthopaedic Surgery Physician

28Total paid$101K

24GClaims3,356

24DCodes billed6

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Orthopaedic Surgery Physician providers in South Dakota

Rank by total paid#3 of 8

Median peer was paid$13K

This provider vs. median7.9×

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 WORSLEY, THOMAS controls 13+ 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	627	$16K
2019	575	$15K
2020	284	$8K
2021	468	$14K
2022	557	$16K
2023	438	$13K
2024incomplete	407	$18K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	76%	2,641	2,168	$77K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	9.5%	225	193	$10K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	7.3%	137	116	$7K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	6.6%	318	267	$7K
20610		<1%	14	13	$321.67
73030		<1%	21	13	$56.55

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 officialWORSLEY, THOMAS (PRESIDENT SPEARFISH HOSPITAL)

Same official

Other billing entities under WORSLEY, THOMAS

Full network →

Provider	Location	Paid
Monument Health Network, INC.	Spearfish, SD	$2.02M
Monument Health Network, INC.	Spearfish, SD	$1.82M
Monument Health Network, INC.	Belle Fourche, SD	$879K
Monument Health Network, INC.	Spearfish, SD	$743K
Monument Health Network, INC.	Spearfish, SD	$441K
Monument Health Network, INC.	Spearfish, SD	$220K
Monument Health Network, INC.	Newcastle, WY	$94K
Monument Health Network, INC.	Spearfish, SD	$18K
Monument Health Network, INC.	Spearfish, SD	$15K
Monument Health Network, INC.	Belle Fourche, SD	$14K
Monument Health Network, INC.	Spearfish, SD	$8K
Monument Health Network, INC.	Spearfish, SD	$2K
Monument Health Network, INC.	Buffalo, SD	$2K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.