MOUNTAIN STATES HEALTH ALLIANCE
NPI: 1205846508
· MOUNTAIN CITY, TN 37683
· 207Q00000X
$140K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,785 |
$25K |
| 2019 |
1,610 |
$22K |
| 2020 |
765 |
$9K |
| 2021 |
675 |
$10K |
| 2022 |
2,008 |
$14K |
| 2023 |
3,211 |
$31K |
| 2024 |
1,837 |
$30K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
4,294 |
3,074 |
$84K |
| 99213 |
|
3,106 |
2,449 |
$48K |
| 99442 |
|
221 |
187 |
$2K |
| 99441 |
|
215 |
166 |
$2K |
| 90686 |
|
337 |
268 |
$1K |
| 99396 |
|
18 |
12 |
$1K |
| 87635 |
|
23 |
14 |
$520.20 |
| 96372 |
|
79 |
38 |
$303.29 |
| 99309 |
|
13 |
12 |
$133.52 |
| G0444 |
Depression screen annual |
143 |
97 |
$118.31 |
| 3078F |
|
1,126 |
768 |
$110.00 |
| G2211 |
Complex e/m visit add on |
90 |
74 |
$92.11 |
| 90471 |
|
18 |
12 |
$89.48 |
| G0439 |
Ppps, subseq visit |
201 |
134 |
$85.17 |
| 3074F |
|
1,036 |
678 |
$80.00 |
| 3077F |
|
219 |
158 |
$80.00 |
| G0008 |
Admin influenza virus vac |
106 |
78 |
$15.42 |
| 3075F |
|
60 |
52 |
$10.00 |
| 4010F |
|
525 |
371 |
$0.00 |
| 3079F |
|
33 |
27 |
$0.00 |
| 99397 |
|
28 |
21 |
$0.00 |