Medicaid Provider Spending

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

MOUNTAIN STATES HEALTH ALLIANCE

NPI: 1114033628 · JOHNSON CITY, TN 37604 · General Acute Care Hospital · NPI assigned 08/21/2006

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

Authorized official HILTON, SHANE controls 20+ related entities in our dataset. Read more

$8.14M
Total Medicaid Paid
145,505
Total Claims
127,705
Beneficiaries
70
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date08/21/2006

Related Entities

Other providers sharing the same authorized official: HILTON, SHANE

ProviderCityStateTotal Paid
JOHNSTON MEMORIAL HOSPITAL, INC ABINGDON VA $35.91M
WELLMONT HEALTH SYSTEM BIG STONE GAP VA $33.71M
MOUNTAIN STATES HEALTH ALLIANCE JOHNSON CITY TN $31.31M
WELLMONT MEDICAL ASSOCIATES INC KINGSPORT TN $27.84M
WELLMONT HEALTH SYSTEM BRISTOL TN $27.35M
TAKOMA REGIONAL HOSPITAL INC GREENEVILLE TN $20.22M
WELLMONT HEALTH SYSTEM KINGSPORT TN $17.64M
MOUNTAIN STATES HEALTH ALLIANCE KINGSPORT TN $15.47M
SMYTH COUNTY COMMUNITY HOSPITAL MARION VA $15.33M
MOUNTAIN STATES HEALTH ALLIANCE LEBANON VA $11.37M
MOUNTAIN STATES HEALTH ALLIANCE PENNINGTON GAP VA $8.28M
MOUNTAIN STATES HEALTH ALLIANCE ELIZABETHTON TN $7.25M
DICKENSON COMMUNITY HOSPITAL, INC. CLINTWOOD VA $6.94M
WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC ROGERSVILLE TN $5.11M
EAST TENNESSEE HEALTHCARE HOLDINGS INC GRAY TN $3.30M
MOUNTAIN STATES HEALTH ALLIANCE MOUNTAIN CITY TN $3.03M
WELLMONT HEALTH SYSTEM SNEEDVILLE TN $1.90M
MOUNTAIN STATES HEALTH ALLIANCE ERWIN TN $1.48M
WILSON PHARMACY INC JOHNSON CITY TN $1.26M
MOUNTAIN STATES HEALTH ALLIANCE NORTON VA $376K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 14,521 $798K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 14,929 13,394 $3.27M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 10,293 9,139 $2.93M
99283 Emergency department visit for the evaluation and management, moderate severity 6,301 5,935 $939K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 10,545 9,432 $324K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,602 1,430 $143K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 19,860 17,331 $96K
74177 Computed tomography, abdomen and pelvis; with contrast material 1,198 1,082 $89K
80053 Comprehensive metabolic panel 15,844 13,865 $58K
96375 Therapeutic injection; each additional sequential IV push 4,422 3,943 $39K
84484 2,731 2,163 $34K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 4,608 3,819 $19K
83690 3,494 3,165 $18K
96361 Intravenous infusion, hydration; each additional hour 2,269 1,907 $18K
99282 Emergency department visit for the evaluation and management, low to moderate severity 162 155 $16K
J2405 Injection, ondansetron hydrochloride, per 1 mg 4,318 3,911 $16K
36415 Collection of venous blood by venipuncture 9,497 8,082 $13K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 28 27 $10K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 919 847 $9K
0001A 355 272 $9K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,809 858 $7K
71046 Radiologic examination, chest; 2 views 1,263 1,186 $6K
0002A 222 171 $6K
81025 1,747 1,640 $6K
83735 1,322 1,109 $5K
81001 6,340 5,711 $5K
80048 Basic metabolic panel (calcium, ionized) 2,065 1,800 $5K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 134 127 $5K
70450 Computed tomography, head or brain; without contrast material 154 132 $4K
84703 618 575 $4K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 223 198 $4K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 14 12 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 422 412 $3K
71045 Radiologic examination, chest; single view 1,063 921 $2K
87077 730 706 $2K
94761 636 272 $2K
74176 Computed tomography, abdomen and pelvis; without contrast material 71 66 $2K
81003 2,880 2,617 $2K
G0378 Hospital observation service, per hour 16 12 $2K
0071A 52 52 $2K
87088 233 214 $1K
85027 340 286 $1K
85379 116 106 $1K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 328 310 $1K
87040 164 80 $909.51
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 2,784 2,488 $880.12
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 15 14 $667.03
85610 352 321 $616.61
83880 63 52 $572.43
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 58 50 $569.25
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 112 104 $376.08
83605 89 76 $328.62
0003A 14 14 $320.00
85730 97 86 $224.90
73630 29 24 $161.68
87081 13 13 $134.08
72100 16 14 $126.10
87086 Culture, bacterial; quantitative colony count, urine 23 20 $118.15
82565 45 40 $93.66
J2270 Injection, morphine sulfate, up to 10 mg 227 212 $60.33
J2360 Injection, orphenadrine citrate, up to 60 mg 44 41 $51.05
87186 12 12 $44.76
J2704 Injection, propofol, 10 mg 156 129 $23.87
J7030 Infusion, normal saline solution , 1000 cc 901 783 $22.67
J7120 Ringers lactate infusion, up to 1000 cc 53 41 $7.55
J1885 Injection, ketorolac tromethamine, per 15 mg 3,852 3,518 $6.38
J2274 Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg 12 12 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 150 133 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 13 12 $0.00
96376 23 12 $0.00
88305 Level IV - Surgical pathology, gross and microscopic examination 15 12 $0.00