Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $8.14M by Medicaid between Jan 2018 and Dec 2024, across 70 billing codes. Its largest line is 99284, emergency room visit (serious) — 40% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
JOHNSON CITY, TN 37604
JOHNSON CITY, TN 37604
33aNPI1114033628assigned 08/21/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$8.14M
24GClaims145,505
24DCodes billed70
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Tennessee
Rank by total paid#31 of 71
Median peer was paid$6.96M
This provider vs. median1.2×
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 | 31,973 | $1.66M | |
| 2019 | 31,163 | $1.45M | |
| 2020 | 14,564 | $812K | |
| 2021 | 17,612 | $1.07M | |
| 2022 | 18,384 | $1.30M | |
| 2023 | 17,288 | $1.05M | |
| 2024incomplete | 14,521 | $798K |
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 | 40% | 14,929 | 13,394 | $3.27M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 36% | 10,293 | 9,139 | $2.93M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 12% | 6,301 | 5,935 | $939K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 4.0% | 10,545 | 9,432 | $324K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.8% | 1,602 | 1,430 | $143K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.2% | 19,860 | 17,331 | $96K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 1.1% | 1,198 | 1,082 | $89K |
| 80053 | Comprehensive metabolic panel | <1% | 15,844 | 13,865 | $58K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 4,422 | 3,943 | $39K |
| 84484 | <1% | 2,731 | 2,163 | $34K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 4,608 | 3,819 | $19K |
| 83690 | <1% | 3,494 | 3,165 | $18K |
58 more codes
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 2,269 | $18K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 162 | $16K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 4,318 | $16K |
| 36415 | Collection of venous blood by venipuncture | <1% | 9,497 | $13K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 28 | $10K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 919 | $9K |
| 0001A | <1% | 355 | $9K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,809 | $7K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,263 | $6K |
| 0002A | <1% | 222 | $6K | |
| 81025 | <1% | 1,747 | $6K | |
| 83735 | <1% | 1,322 | $5K | |
| 81001 | <1% | 6,340 | $5K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 2,065 | $5K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 134 | $5K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 154 | $4K |
| 84703 | <1% | 618 | $4K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 223 | $4K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 14 | $3K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 422 | $3K |
| 71045 | Radiologic examination, chest; single view | <1% | 1,063 | $2K |
| 87077 | <1% | 730 | $2K | |
| 94761 | <1% | 636 | $2K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 71 | $2K |
| 81003 | <1% | 2,880 | $2K | |
| G0378 | Hospital observation service, per hour | <1% | 16 | $2K |
| 0071A | <1% | 52 | $2K | |
| 87088 | <1% | 233 | $1K | |
| 85027 | <1% | 340 | $1K | |
| 85379 | <1% | 116 | $1K | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 328 | $1K |
| 87040 | <1% | 164 | $909.51 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,784 | $880.12 |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 15 | $667.03 |
| 85610 | <1% | 352 | $616.61 | |
| 83880 | <1% | 63 | $572.43 | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 58 | $569.25 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 112 | $376.08 |
| 83605 | <1% | 89 | $328.62 | |
| 0003A | <1% | 14 | $320.00 | |
| 85730 | <1% | 97 | $224.90 | |
| 73630 | <1% | 29 | $161.68 | |
| 87081 | <1% | 13 | $134.08 | |
| 72100 | <1% | 16 | $126.10 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 23 | $118.15 |
| 82565 | <1% | 45 | $93.66 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 227 | $60.33 |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | <1% | 44 | $51.05 |
| 87186 | <1% | 12 | $44.76 | |
| J2704 | Injection, propofol, 10 mg | <1% | 156 | $23.87 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 901 | $22.67 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 53 | $7.55 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 3,852 | $6.38 |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | 0% | 12 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 150 | $0.00 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 13 | $0.00 |
| 96376 | 0% | 23 | $0.00 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 0% | 15 | $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.