Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $8.28M by Medicaid between Jul 2021 and Dec 2024, across 101 billing codes. Its largest line is 99284, emergency room visit (serious) — 36% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
PENNINGTON GAP, VA 24277
PENNINGTON GAP, VA 24277
33aNPI1205488996assigned 07/12/2019
33bProvider typeCritical Access Hospital
28Total paid$8.28M
24GClaims111,277
24DCodes billed101
24AFirst – last monthJul 2021 – Dec 2024
Compared with peers
Next to other Critical Access Hospital providers in Virginia
Rank by total paid#2 of 8
Median peer was paid$893K
This provider vs. median9.3×
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 | |
|---|---|---|---|
| 2021 | 13,572 | $667K | |
| 2022 | 35,131 | $2.18M | |
| 2023 | 35,394 | $2.97M | |
| 2024incomplete | 27,180 | $2.46M |
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 | 36% | 11,954 | 10,760 | $2.97M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 17% | 6,431 | 5,844 | $1.41M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 10% | 3,431 | 3,060 | $844K |
| 96361 | Intravenous infusion, hydration; each additional hour | 7.6% | 1,721 | 1,460 | $632K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 5.7% | 5,793 | 5,390 | $472K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 4.6% | 1,883 | 1,755 | $382K |
| 70450 | Computed tomography, head or brain; without contrast material | 4.1% | 1,179 | 1,082 | $342K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 3.3% | 989 | 924 | $271K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2.9% | 925 | 868 | $239K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 1.4% | 1,171 | 1,063 | $118K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 1.1% | 966 | 882 | $87K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 200 | 182 | $62K |
89 more codes
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 175 | $57K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 161 | $49K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 77 | $45K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 995 | $33K |
| 80053 | Comprehensive metabolic panel | <1% | 6,092 | $26K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,776 | $25K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 1,706 | $24K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 136 | $22K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 3,867 | $14K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 2,622 | $12K |
| 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 | <1% | 623 | $8K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,679 | $8K |
| 83880 | <1% | 847 | $8K | |
| 87040 | <1% | 1,743 | $7K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 3,157 | $7K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 6,737 | $7K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,091 | $5K |
| 81025 | <1% | 1,328 | $5K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,539 | $5K |
| 73562 | <1% | 303 | $5K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 1,479 | $5K |
| 72100 | <1% | 153 | $4K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 14 | $4K |
| 73630 | <1% | 425 | $4K | |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 85 | $4K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 516 | $4K |
| 81001 | <1% | 2,622 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,170 | $3K |
| 90715 | <1% | 98 | $3K | |
| 74018 | <1% | 109 | $3K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 27 | $2K |
| 85379 | <1% | 727 | $2K | |
| 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 | <1% | 115 | $2K |
| 84484 | <1% | 2,792 | $2K | |
| 96376 | <1% | 772 | $2K | |
| 73130 | <1% | 184 | $2K | |
| 81003 | <1% | 1,852 | $2K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 128 | $2K |
| 73610 | <1% | 248 | $2K | |
| 73030 | <1% | 106 | $1K | |
| 83735 | <1% | 1,353 | $1K | |
| 73110 | <1% | 84 | $923.40 | |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | <1% | 86 | $816.52 |
| 74022 | <1% | 114 | $811.09 | |
| 80143 | <1% | 159 | $772.82 | |
| 85027 | <1% | 677 | $751.78 | |
| 71250 | <1% | 15 | $743.62 | |
| 83605 | <1% | 1,473 | $733.65 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 1,672 | $715.69 |
| 83690 | <1% | 1,951 | $705.37 | |
| 94760 | <1% | 908 | $688.74 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 943 | $668.17 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 128 | $594.46 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 1,214 | $541.09 |
| 80179 | <1% | 158 | $532.63 | |
| 36600 | <1% | 166 | $450.66 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,328 | $384.64 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 564 | $355.63 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,807 | $339.79 |
| 80061 | Lipid panel | <1% | 43 | $334.37 |
| 87186 | <1% | 341 | $288.19 | |
| 82805 | <1% | 52 | $280.49 | |
| 85610 | <1% | 389 | $239.63 | |
| 87077 | <1% | 316 | $197.23 | |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 178 | $176.58 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 97 | $165.10 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 993 | $155.55 |
| J0780 | Injection, prochlorperazine, up to 10 mg | <1% | 187 | $153.28 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 32 | $138.23 |
| 82803 | <1% | 222 | $93.24 | |
| 87081 | <1% | 930 | $80.53 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 746 | $54.48 |
| 82375 | <1% | 52 | $53.66 | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 41 | $51.31 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | <1% | 38 | $50.43 |
| 84703 | <1% | 73 | $34.63 | |
| J2060 | Injection, lorazepam, 2 mg | <1% | 96 | $32.95 |
| 83050 | <1% | 52 | $31.35 | |
| J8540 | Dexamethasone, oral, 0.25 mg | <1% | 80 | $27.66 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | <1% | 355 | $22.34 |
| 84439 | <1% | 12 | $18.26 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 78 | $4.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 57 | $1.92 |
| J1940 | Injection, furosemide, up to 20 mg | <1% | 17 | $1.20 |
| J1815 | Injection, insulin, per 5 units | <1% | 23 | $0.48 |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 0% | 14 | $0.00 |
| 85007 | 0% | 14 | $0.00 | |
| 87205 | 0% | 15 | $0.00 | |
| 87070 | 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.