Clinic
Monument Health Network, INC.
Monument Health Network, INC. was paid $743K by Medicaid between Jan 2018 and Dec 2024, across 70 billing codes. Its largest line is 99284, emergency room visit (serious) — 33% of everything it billed.
33Billing provider infoMONUMENT HEALTH NETWORK, INC.
SPEARFISH, SD 57783
SPEARFISH, SD 57783
33aNPI1174569347assigned 06/22/2006
33bProvider typeMulti-Specialty Clinic/Center
28Total paid$743K
24GClaims20,226
24DCodes billed70
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Multi-Specialty Clinic/Center providers in South Dakota
Rank by total paid#7 of 24
Median peer was paid$251K
This provider vs. median3.0×
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 | 1,443 | $72K | |
| 2019 | 1,741 | $74K | |
| 2020 | 10,077 | $235K | |
| 2021 | 2,013 | $96K | |
| 2022 | 1,828 | $88K | |
| 2023 | 1,557 | $77K | |
| 2024incomplete | 1,567 | $100K |
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 | 33% | 3,576 | 2,922 | $242K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 31% | 4,593 | 3,918 | $228K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 7.9% | 2,162 | 1,959 | $59K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 3.4% | 340 | 219 | $25K |
| A0430 | Ambulance service, conventional air services, transport, one way (fixed wing) | 2.6% | 22 | 22 | $20K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.3% | 837 | 681 | $17K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 2.2% | 1,453 | 612 | $17K |
| 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 | 2.0% | 575 | 414 | $15K |
| A0435 | Fixed wing air mileage, per statute mile | 1.7% | 22 | 22 | $12K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 1.5% | 278 | 277 | $11K |
| 90999 | Dialysis (unlisted procedure)Unlisted dialysis procedure, inpatient or outpatient | 1.4% | 699 | 17 | $10K |
| A0427 | Emergency ambulance ride, advanced life supportAmbulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1.1% | 104 | 88 | $8K |
58 more codes
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.0% | 1,317 | $7K |
| A0429 | Emergency ambulance ride, basic life support | <1% | 76 | $6K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 572 | $5K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 342 | $5K |
| A0425 | Ground mileage, per statute mile | <1% | 234 | $5K |
| G0008 | Administration of influenza virus vaccine | <1% | 310 | $4K |
| 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | <1% | 13 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 126 | $4K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 73 | $3K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 218 | $3K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 149 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 33 | $3K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 192 | $3K |
| 00170 | Anesthesia for intraoral procedures, including biopsy | <1% | 12 | $2K |
| A9270 | Non-covered item or service | <1% | 161 | $2K |
| E0601 | Continuous positive airway pressure (cpap) device | <1% | 58 | $1K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 80 | $1K |
| 99223 | Prolong inpt eval add15 m | <1% | 33 | $1K |
| A7030 | Full face mask used with positive airway pressure device, each | <1% | 48 | $1K |
| A7031 | Face mask interface, replacement for full face mask, each | <1% | 47 | $1K |
| 90863 | <1% | 58 | $1K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 13 | $1K |
| E1392 | Portable oxygen concentrator, rental | <1% | 61 | $984.08 |
| 97161 | <1% | 53 | $821.29 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 80 | $780.05 |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 41 | $739.00 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 31 | $722.30 |
| A4604 | Tubing with integrated heating element for use with positive airway pressure device | <1% | 66 | $631.16 |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 30 | $600.05 |
| K0738 | Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing | <1% | 15 | $517.60 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | <1% | 58 | $512.47 |
| Q3014 | Telehealth originating site facility fee | <1% | 40 | $454.14 |
| 71045 | Radiologic examination, chest; single view | <1% | 150 | $446.62 |
| J7626 | Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg | <1% | 26 | $402.27 |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 26 | $396.04 |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 16 | $390.00 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 26 | $367.34 |
| Q0513 | Pharmacy dispensing fee for inhalation drug(s); per 30 days | <1% | 61 | $336.60 |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 61 | $319.59 |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 18 | $315.76 |
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | <1% | 105 | $287.90 |
| A7038 | Filter, disposable, used with positive airway pressure device | <1% | 78 | $266.19 |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 18 | $264.47 |
| E0570 | Nebulizer, with compressor | <1% | 68 | $256.88 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 34 | $235.72 |
| A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | <1% | 14 | $211.67 |
| A7035 | Headgear used with positive airway pressure device | <1% | 36 | $179.40 |
| 99442 | <1% | 15 | $166.58 | |
| 99307 | <1% | 12 | $118.49 | |
| 93296 | <1% | 14 | $94.70 | |
| A7046 | Water chamber for humidifier, used with positive airway pressure device, replacement, each | <1% | 34 | $94.62 |
| K0001 | Standard wheelchair | <1% | 12 | $74.36 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 31 | $68.50 |
| E0562 | Humidifier, heated, used with positive airway pressure device | <1% | 14 | $59.47 |
| A4357 | Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each | <1% | 17 | $54.11 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 12 | $14.05 |
| A4259 | Lancets, per box of 100 | <1% | 14 | $3.08 |
| 36415 | Collection of venous blood by venipuncture | 0% | 13 | $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 officialWORSLEY, THOMAS (PRESIDENT SPEARFISH HOSPITAL)
| 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 | $441K |
| Monument Health Network, INC. | Spearfish, SD | $220K |
| Monument Health Network, INC. | Spearfish, SD | $101K |
| 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.