Medicaid Provider Spending

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

MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.

NPI: 1265549919 · ASHEVILLE, NC 28803 · Family Medicine Physician · NPI assigned 08/25/2006

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

Authorized official HATHAWAY, WILLIAM controls 20+ related entities in our dataset. Read more

$17.53M
Total Medicaid Paid
443,242
Total Claims
281,543
Beneficiaries
77
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHATHAWAY, WILLIAM (CEO)
NPI Enumeration Date08/25/2006

Related Entities

Other providers sharing the same authorized official: HATHAWAY, WILLIAM

ProviderCityStateTotal Paid
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $14.23M
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. CANDLER NC $7.16M
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $5.47M
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $1.67M
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. FLETCHER NC $1.55M
MISSION HOSPITALS INC ASHEVILLE NC $1.22M
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $971K
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $843K
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $651K
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. ASHEVILLE NC $647K
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC. FRANKLIN NC $164K
MISSION HOSPITALS INC ASHEVILLE NC $69K
MISSION HOSPITALS INC ASHEVILLE NC $25K
MISSION HOSPITAL INC ASHEVILLE NC $14K
MISSION HOSPITALS, INC ASHEVILLE NC $13K
MISSION HOSPITALS, INC ASHEVILLE NC $4K
MISSION HOSPITALS INC ASHEVILLE NC $3K
MISSION HOSPITALS, INC. ARDEN NC $2K
MISSION HOSPITAL, INC. ASHEVILLE NC $1K
MISSION HOSPITALS, INC. ASHEVILLE NC $189.21

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 45,306 $1.32M
2019 43,818 $1.45M
2020 38,643 $1.64M
2021 56,919 $1.93M
2022 106,098 $3.87M
2023 88,830 $4.00M
2024 63,628 $3.31M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 48,262 34,094 $8.46M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 46,878 30,409 $2.13M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 49,898 34,633 $1.63M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 21,804 15,499 $1.04M
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 7,386 5,654 $703K
99199 Unlisted special service, procedure or report 125,696 62,167 $651K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 7,730 5,727 $475K
59025 Fetal non-stress test 27,050 17,073 $471K
76818 6,147 3,411 $330K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 4,496 3,276 $223K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 369 290 $217K
59410 352 252 $213K
99238 Hospital discharge day management, 30 minutes or less 1,987 1,603 $103K
76819 Fetal biophysical profile; without non-stress testing 2,656 1,619 $97K
76820 3,756 1,877 $95K
99232 Subsequent hospital care, per day, moderate complexity 1,854 1,197 $95K
76830 Ultrasound, transvaginal 1,615 1,169 $73K
80305 6,850 4,328 $57K
99243 654 558 $51K
76801 621 478 $49K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1,402 997 $39K
S0281 Medical home program, comprehensive care coordination and planning, maintenance of plan 535 378 $38K
S0280 Medical home program, comprehensive care coordination and planning, initial plan 1,466 1,157 $35K
36415 Collection of venous blood by venipuncture 21,039 15,574 $34K
81003 16,389 10,998 $29K
81025 6,345 4,521 $28K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,031 699 $28K
99241 678 560 $21K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,208 1,489 $13K
96127 4,791 3,363 $11K
99242 213 172 $11K
85018 4,928 3,873 $11K
59514 15 12 $8K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 910 622 $8K
99215 Prolong outpt/office vis 174 119 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 636 456 $6K
76825 48 38 $6K
J1050 Injection, medroxyprogesterone acetate, 1 mg 152 104 $5K
90715 197 130 $5K
99493 69 44 $4K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 91 67 $2K
S9442 Birthing classes, non-physician provider, per session 294 192 $2K
99283 Emergency department visit for the evaluation and management, moderate severity 52 40 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 22 20 $2K
90686 291 191 $2K
99222 Initial hospital care, per day, moderate complexity 15 12 $2K
93325 47 38 $1K
99284 Emergency department visit for the evaluation and management, high severity 19 13 $1K
99281 Emergency department visit for the evaluation and management, self-limited or minor 71 59 $930.41
99443 21 12 $745.29
99244 Office or other outpatient consultation, moderate to high complexity 14 13 $306.66
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 53 39 $183.91
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 33 25 $153.80
87210 50 25 $123.27
81001 164 112 $122.97
83036 Hemoglobin; glycosylated (A1C) 501 408 $95.76
82951 293 268 $15.88
82947 61 50 $9.68
36416 727 626 $9.48
86703 1,972 1,675 $0.00
87653 60 55 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 53 42 $0.00
2014F 56 38 $0.00
G0512 Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month 23 15 $0.00
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 14 13 $0.00
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 94 66 $0.00
99000 1,253 708 $0.00
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 2,702 2,096 $0.00
87088 2,858 2,286 $0.00
4037F 15 14 $0.00
86780 605 551 $0.00
80055 250 199 $0.00
3008F 976 784 $0.00
99024 94 68 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 70 66 $0.00
88305 Level IV - Surgical pathology, gross and microscopic examination 14 12 $0.00
84443 Thyroid stimulating hormone (TSH) 27 25 $0.00