Medicaid Provider Spending

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

MOUNTAIN STATES HEALTH ALLIANCE

NPI: 1205488996 · PENNINGTON GAP, VA 24277 · Critical Access Hospital · NPI assigned 07/12/2019

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

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

$8.28M
Total Medicaid Paid
111,277
Total Claims
97,826
Beneficiaries
101
Codes Billed
2021-07
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date07/12/2019

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 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
2021 13,572 $667K
2022 35,131 $2.18M
2023 35,394 $2.97M
2024 27,180 $2.46M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 11,954 10,760 $2.97M
99283 Emergency department visit for the evaluation and management, moderate severity 6,431 5,844 $1.41M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 3,431 3,060 $844K
96361 Intravenous infusion, hydration; each additional hour 1,721 1,460 $632K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 5,793 5,390 $472K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1,883 1,755 $382K
70450 Computed tomography, head or brain; without contrast material 1,179 1,082 $342K
74176 Computed tomography, abdomen and pelvis; without contrast material 989 924 $271K
74177 Computed tomography, abdomen and pelvis; with contrast material 925 868 $239K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,171 1,063 $118K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 966 882 $87K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 200 182 $62K
71275 Computed tomographic angiography, chest, with contrast material 175 161 $57K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 161 127 $49K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 77 76 $45K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 995 894 $33K
80053 Comprehensive metabolic panel 6,092 5,220 $26K
71046 Radiologic examination, chest; 2 views 1,776 1,680 $25K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 1,706 1,573 $24K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 136 130 $22K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 3,867 3,206 $14K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 2,622 2,465 $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 623 560 $8K
71045 Radiologic examination, chest; single view 2,679 2,392 $8K
83880 847 760 $8K
87040 1,743 889 $7K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 3,157 2,827 $7K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 6,737 5,697 $7K
36415 Collection of venous blood by venipuncture 2,091 1,850 $5K
81025 1,328 1,230 $5K
96375 Therapeutic injection; each additional sequential IV push 2,539 2,110 $5K
73562 303 291 $5K
80048 Basic metabolic panel (calcium, ionized) 1,479 1,299 $5K
72100 153 147 $4K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 14 14 $4K
73630 425 396 $4K
72125 Computed tomography, cervical spine; without contrast material 85 78 $4K
84443 Thyroid stimulating hormone (TSH) 516 493 $4K
81001 2,622 2,373 $3K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,170 1,962 $3K
90715 98 93 $3K
74018 109 106 $3K
76705 Ultrasound, abdominal, real time with image documentation; limited 27 24 $2K
85379 727 682 $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 115 112 $2K
84484 2,792 2,194 $2K
96376 772 606 $2K
73130 184 176 $2K
81003 1,852 1,697 $2K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 128 119 $2K
73610 248 230 $2K
73030 106 101 $1K
83735 1,353 1,147 $1K
73110 84 78 $923.40
0202U Oncology (prostate), multianalyte, gene expression profiling 86 85 $816.52
74022 114 108 $811.09
80143 159 143 $772.82
85027 677 623 $751.78
71250 15 15 $743.62
83605 1,473 1,059 $733.65
J2405 Injection, ondansetron hydrochloride, per 1 mg 1,672 1,438 $715.69
83690 1,951 1,763 $705.37
94760 908 803 $688.74
87086 Culture, bacterial; quantitative colony count, urine 943 860 $668.17
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 128 107 $594.46
J0696 Injection, ceftriaxone sodium, per 250 mg 1,214 1,044 $541.09
80179 158 143 $532.63
36600 166 145 $450.66
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,328 1,174 $384.64
J2270 Injection, morphine sulfate, up to 10 mg 564 457 $355.63
J1885 Injection, ketorolac tromethamine, per 15 mg 1,807 1,636 $339.79
80061 Lipid panel 43 40 $334.37
87186 341 304 $288.19
82805 52 46 $280.49
85610 389 348 $239.63
87077 316 292 $197.23
J1170 Injection, hydromorphone, up to 4 mg 178 135 $176.58
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 97 77 $165.10
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 993 935 $155.55
J0780 Injection, prochlorperazine, up to 10 mg 187 175 $153.28
83036 Hemoglobin; glycosylated (A1C) 32 29 $138.23
82803 222 143 $93.24
87081 930 874 $80.53
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 746 352 $54.48
82375 52 46 $53.66
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 41 40 $51.31
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 38 34 $50.43
84703 73 68 $34.63
J2060 Injection, lorazepam, 2 mg 96 80 $32.95
83050 52 46 $31.35
J8540 Dexamethasone, oral, 0.25 mg 80 76 $27.66
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 355 343 $22.34
84439 12 12 $18.26
J1200 Injection, diphenhydramine hcl, up to 50 mg 78 72 $4.00
J7030 Infusion, normal saline solution , 1000 cc 57 46 $1.92
J1940 Injection, furosemide, up to 20 mg 17 12 $1.20
J1815 Injection, insulin, per 5 units 23 12 $0.48
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 14 13 $0.00
85007 14 14 $0.00
87205 15 12 $0.00
87070 15 12 $0.00