Medicaid Provider Spending

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

WELLMONT HEALTH SYSTEM

NPI: 1124058615 · BRISTOL, TN 37620 · General Acute Care Hospital · NPI assigned 07/03/2006

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

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

$27.35M
Total Medicaid Paid
593,002
Total Claims
461,644
Beneficiaries
242
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date07/03/2006

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
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 JOHNSON CITY TN $8.14M
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 72,913 $2.86M
2019 94,908 $3.34M
2020 78,573 $3.44M
2021 90,579 $4.08M
2022 88,415 $4.28M
2023 95,410 $4.96M
2024 72,204 $4.38M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 42,726 37,393 $8.49M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 19,791 16,974 $3.91M
99283 Emergency department visit for the evaluation and management, moderate severity 19,684 17,490 $2.76M
96361 Intravenous infusion, hydration; each additional hour 6,477 5,151 $1.62M
74177 Computed tomography, abdomen and pelvis; with contrast material 4,682 4,224 $915K
41899 Unlisted procedure, dentoalveolar structures 948 911 $834K
70450 Computed tomography, head or brain; without contrast material 4,294 3,779 $728K
G0378 Hospital observation service, per hour 5,741 3,672 $605K
99282 Emergency department visit for the evaluation and management, low to moderate severity 4,953 4,479 $504K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 10,484 3,110 $446K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,782 1,608 $361K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,341 1,229 $359K
29581 2,487 737 $340K
97530 Therapeutic activities, direct patient contact, each 15 minutes 6,238 2,329 $296K
0202U Oncology (prostate), multianalyte, gene expression profiling 2,874 2,748 $288K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 484 449 $282K
97602 1,538 503 $275K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 1,813 1,576 $231K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 2,889 2,111 $228K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 4,161 3,798 $221K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 2,071 1,485 $206K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 3,487 2,449 $205K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 4,474 3,825 $195K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,236 1,138 $192K
71275 Computed tomographic angiography, chest, with contrast material 544 501 $140K
59025 Fetal non-stress test 775 563 $136K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,451 1,330 $131K
80053 Comprehensive metabolic panel 36,823 30,237 $127K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 16,974 14,447 $127K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,133 849 $100K
71046 Radiologic examination, chest; 2 views 11,273 9,935 $100K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 538 485 $99K
97162 1,468 1,326 $97K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 392 237 $96K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 45,926 36,851 $78K
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography 359 321 $77K
93017 774 712 $75K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 261 243 $74K
77067 Screening mammography, bilateral, including computer-aided detection 1,778 1,683 $74K
78306 322 289 $73K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,018 905 $64K
72141 345 328 $60K
80048 Basic metabolic panel (calcium, ionized) 12,272 9,338 $52K
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 2,217 2,071 $51K
99281 Emergency department visit for the evaluation and management, self-limited or minor 563 500 $50K
97116 2,153 823 $44K
93971 540 487 $41K
72100 2,143 1,951 $40K
78815 Positron emission tomography (PET) for limited area imaging 78 71 $39K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 14,812 12,148 $37K
49083 60 37 $36K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 242 173 $33K
76700 Ultrasound, abdominal, real time with image documentation; complete 241 228 $33K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 63 57 $25K
36415 Collection of venous blood by venipuncture 19,109 12,977 $24K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 2,548 2,113 $23K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 134 128 $23K
83880 3,393 2,870 $22K
71045 Radiologic examination, chest; single view 5,162 4,493 $21K
72125 Computed tomography, cervical spine; without contrast material 960 876 $20K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 449 409 $19K
84484 11,595 7,813 $17K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 793 339 $16K
70551 Magnetic resonance imaging, brain; without contrast material 71 64 $16K
73562 1,483 1,297 $15K
95813 31 30 $14K
74018 1,473 1,315 $13K
95816 66 64 $13K
72131 272 241 $12K
99215 Prolong outpt/office vis 54 40 $12K
87040 1,671 830 $12K
76536 120 114 $12K
81025 8,018 6,975 $11K
76642 100 96 $11K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 338 118 $11K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 8,665 7,610 $10K
J7030 Infusion, normal saline solution , 1000 cc 8,987 6,837 $10K
85027 6,036 4,984 $9K
95810 Polysomnography; sleep staging with 4 or more additional parameters 12 12 $9K
84443 Thyroid stimulating hormone (TSH) 2,525 2,301 $9K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 52 50 $8K
29445 49 13 $8K
73630 972 883 $8K
77063 Screening digital breast tomosynthesis, bilateral 260 249 $8K
93923 83 78 $8K
71250 102 96 $8K
81001 17,007 14,508 $7K
70496 28 24 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 7,684 5,534 $7K
J7120 Ringers lactate infusion, up to 1000 cc 5,416 4,284 $7K
73030 841 744 $7K
J2405 Injection, ondansetron hydrochloride, per 1 mg 14,350 10,717 $7K
90715 335 318 $6K
72040 168 154 $6K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 7,414 5,966 $6K
62323 32 26 $5K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 97 92 $5K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 493 439 $5K
76770 30 28 $4K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 267 253 $4K
76830 Ultrasound, transvaginal 44 39 $4K
73130 661 599 $4K
73502 384 350 $4K
73610 740 651 $4K
96375 Therapeutic injection; each additional sequential IV push 7,602 5,927 $4K
80061 Lipid panel 947 884 $4K
85379 979 905 $4K
J3010 Injection, fentanyl citrate, 0.1 mg 6,370 5,017 $4K
83036 Hemoglobin; glycosylated (A1C) 905 859 $4K
J7050 Infusion, normal saline solution, 250 cc 1,028 480 $4K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 3,242 1,756 $3K
72050 133 123 $3K
J2250 Injection, midazolam hydrochloride, per 1 mg 5,977 5,027 $3K
83690 7,954 6,776 $3K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 16 13 $3K
77066 Tomosynthesis, mammo 58 52 $3K
77002 13 12 $3K
83735 3,147 2,172 $3K
97165 15 15 $3K
77065 Tomosynthesis, mammo 60 54 $2K
72020 145 127 $2K
12001 13 13 $2K
81003 7,131 6,252 $2K
96376 3,364 1,863 $2K
J1650 Injection, enoxaparin sodium, 10 mg 2,707 1,299 $2K
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 227 168 $2K
88307 130 102 $2K
97535 Self-care/home management training, each 15 minutes 95 77 $2K
97166 15 14 $2K
87205 134 124 $2K
85652 1,044 905 $2K
86140 441 383 $2K
85610 2,200 1,783 $2K
93880 33 29 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 7,235 5,638 $2K
76801 34 30 $2K
J3490 Unclassified drugs 4,066 1,612 $1K
83605 1,186 909 $1K
77336 29 12 $1K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 82 80 $1K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 71 58 $1K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,578 1,367 $1K
A9585 Injection, gadobutrol, 0.1 ml 1,787 1,634 $1K
J1170 Injection, hydromorphone, up to 4 mg 7,827 4,364 $1K
87086 Culture, bacterial; quantitative colony count, urine 2,985 2,602 $1K
87536 14 13 $1K
85730 753 675 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 409 356 $1K
71271 12 12 $976.84
82565 494 422 $738.32
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 55 49 $729.00
87081 1,106 1,016 $681.17
G0297 Low dose ct scan (ldct) for lung cancer screening 14 12 $680.61
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 304 194 $640.52
73110 149 128 $623.63
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 14 12 $591.70
J2270 Injection, morphine sulfate, up to 10 mg 5,009 3,681 $590.02
86901 1,095 916 $589.40
80076 180 164 $573.73
80143 128 111 $545.60
70486 13 12 $522.08
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 930 883 $513.68
J0696 Injection, ceftriaxone sodium, per 250 mg 3,323 2,238 $503.07
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 14 12 $487.95
84100 981 656 $480.66
70498 15 12 $400.42
87210 186 160 $341.80
85055 67 50 $325.71
80179 122 110 $324.04
82607 40 39 $297.59
72072 12 12 $296.04
87186 859 767 $290.16
86850 654 539 $267.45
84702 453 389 $261.78
80320 294 246 $246.70
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 353 292 $237.43
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 56 49 $218.28
J0690 Injection, cefazolin sodium, 500 mg 4,029 2,896 $213.80
J2785 Injection, regadenoson, 0.1 mg 215 201 $199.26
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,129 1,025 $182.15
86900 1,020 848 $181.81
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,491 1,219 $177.97
J2360 Injection, orphenadrine citrate, up to 60 mg 860 773 $167.93
82570 110 92 $162.74
84439 62 58 $160.68
87077 837 743 $159.92
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 437 318 $141.09
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 19 19 $137.45
84703 293 277 $130.04
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 484 344 $108.47
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 498 463 $107.92
87070 149 138 $104.05
82728 12 12 $77.50
94760 6,499 4,036 $66.52
J1815 Injection, insulin, per 5 units 692 311 $66.23
88304 140 129 $49.68
A9270 Non-covered item or service 7,376 1,127 $49.65
36600 31 24 $48.14
99152 151 134 $36.04
J0780 Injection, prochlorperazine, up to 10 mg 586 493 $34.78
J1630 Injection, haloperidol, up to 5 mg 279 227 $32.42
J2060 Injection, lorazepam, 2 mg 284 199 $25.57
82140 13 13 $24.68
A9503 Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries 388 349 $23.64
J2370 Injection, phenylephrine hcl, up to 1 ml 717 595 $23.29
84156 34 25 $22.43
85007 32 25 $20.96
87807 256 237 $19.63
J2550 Injection, promethazine hcl, up to 50 mg 280 204 $18.79
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 150 98 $18.32
73080 17 12 $10.51
J2765 Injection, metoclopramide hcl, up to 10 mg 86 71 $6.76
83615 14 12 $5.05
J0330 Injection, succinylcholine chloride, up to 20 mg 20 13 $1.79
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 13 13 $1.76
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 151 63 $1.45
J1644 Injection, heparin sodium, per 1000 units 52 42 $0.71
J1940 Injection, furosemide, up to 20 mg 15 12 $0.09
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 51 45 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 93 72 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 141 113 $0.00
J0688 Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg 73 67 $0.00
J3370 Injection, vancomycin hcl, 500 mg 79 65 $0.00
J0735 Injection, clonidine hydrochloride, 1 mg 81 77 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 49 38 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 92 72 $0.00
J1171 Injection, hydromorphone, 0.1 mg 122 81 $0.00
C9113 Injection, pantoprazole sodium, per vial 26 12 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 43 38 $0.00
76000 51 45 $0.00
C1776 Joint device (implantable) 12 12 $0.00
J2795 Injection, ropivacaine hydrochloride, 1 mg 111 101 $0.00
C1769 Guide wire 258 232 $0.00
J2704 Injection, propofol, 10 mg 4,184 3,018 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 491 403 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 53 26 $0.00
99153 Mod sedat endo service >5yrs 26 24 $0.00
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 52 41 $0.00
94761 40 27 $0.00
J2373 Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms 16 16 $0.00
71101 28 25 $0.00
73090 29 25 $0.00