Medicaid Provider Spending

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

WELLMONT HEALTH SYSTEM

NPI: 1487690400 · KINGSPORT, TN 37660 · General Acute Care Hospital · NPI assigned 06/20/2006

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

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

$17.64M
Total Medicaid Paid
422,589
Total Claims
337,746
Beneficiaries
160
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date06/20/2006

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
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 PENNINGTON GAP VA $8.28M
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
2018 79,345 $2.82M
2019 79,580 $2.61M
2020 56,909 $2.73M
2021 57,929 $2.63M
2022 50,555 $2.27M
2023 59,916 $2.65M
2024 38,355 $1.93M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 35,151 30,280 $7.05M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 16,145 13,466 $3.53M
99283 Emergency department visit for the evaluation and management, moderate severity 17,946 15,974 $2.42M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,847 1,647 $473K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 818 708 $360K
99282 Emergency department visit for the evaluation and management, low to moderate severity 4,985 4,576 $358K
74177 Computed tomography, abdomen and pelvis; with contrast material 2,227 1,957 $355K
96361 Intravenous infusion, hydration; each additional hour 1,552 1,211 $305K
70450 Computed tomography, head or brain; without contrast material 2,690 2,240 $302K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 3,152 2,768 $194K
G0378 Hospital observation service, per hour 3,332 1,884 $145K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 10,046 8,453 $142K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 47,200 38,582 $114K
93017 1,226 1,073 $111K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,552 1,402 $105K
80053 Comprehensive metabolic panel 38,234 31,761 $98K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 603 537 $91K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 4,221 3,493 $79K
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography 365 320 $78K
71046 Radiologic examination, chest; 2 views 8,994 7,702 $78K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 305 281 $70K
93922 1,091 987 $69K
74176 Computed tomography, abdomen and pelvis; without contrast material 400 358 $67K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,963 1,621 $63K
77067 Screening mammography, bilateral, including computer-aided detection 1,473 1,383 $59K
84484 13,154 9,232 $58K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 19,800 15,684 $54K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 1,131 609 $47K
76705 Ultrasound, abdominal, real time with image documentation; limited 516 472 $46K
93880 591 514 $38K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 578 470 $37K
36415 Collection of venous blood by venipuncture 32,884 25,708 $34K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 729 372 $33K
99281 Emergency department visit for the evaluation and management, self-limited or minor 588 509 $33K
80048 Basic metabolic panel (calcium, ionized) 6,678 5,022 $30K
77412 906 94 $30K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 7,302 6,218 $27K
76641 204 202 $24K
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 832 771 $24K
95886 612 548 $24K
71260 Computed tomography, thorax, diagnostic; with contrast material 394 341 $20K
71045 Radiologic examination, chest; single view 4,825 3,947 $19K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 42 37 $19K
71275 Computed tomographic angiography, chest, with contrast material 73 67 $18K
77336 586 248 $15K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 83 79 $14K
77063 Screening digital breast tomosynthesis, bilateral 562 530 $13K
96375 Therapeutic injection; each additional sequential IV push 3,627 2,876 $13K
J7030 Infusion, normal saline solution , 1000 cc 4,927 3,694 $12K
C1776 Joint device (implantable) 60 52 $12K
83880 2,666 2,111 $12K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 5,053 3,769 $11K
76700 Ultrasound, abdominal, real time with image documentation; complete 311 267 $11K
83690 6,057 5,156 $10K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 201 77 $10K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 223 201 $9K
81001 14,162 12,166 $9K
97162 210 175 $9K
93971 97 82 $8K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 82 70 $8K
72141 46 42 $7K
77014 267 24 $7K
A9585 Injection, gadobutrol, 0.1 ml 1,645 1,504 $7K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 34 28 $7K
97530 Therapeutic activities, direct patient contact, each 15 minutes 164 107 $7K
J2405 Injection, ondansetron hydrochloride, per 1 mg 6,681 5,037 $7K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,005 876 $6K
77334 103 55 $6K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,619 1,481 $6K
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 549 457 $6K
81025 4,114 3,681 $6K
77300 148 76 $5K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 53 48 $4K
81003 6,171 5,354 $4K
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 883 450 $3K
73221 27 25 $3K
62323 12 12 $3K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 233 214 $3K
87040 349 165 $3K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 75 64 $3K
72125 Computed tomography, cervical spine; without contrast material 153 132 $3K
85027 1,771 1,355 $3K
86901 1,079 885 $2K
85610 2,029 1,670 $2K
95911 33 27 $2K
86850 929 761 $2K
87641 149 141 $2K
96376 1,018 565 $2K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 129 128 $2K
72100 119 105 $2K
94760 959 533 $2K
71250 35 29 $1K
87640 103 101 $1K
J7120 Ringers lactate infusion, up to 1000 cc 2,566 1,901 $1K
88342 154 118 $1K
82565 817 724 $1K
95909 28 25 $1K
83735 1,715 1,207 $980.42
J1100 Injection, dexamethasone sodium phosphate, 1 mg 4,014 3,215 $967.03
84443 Thyroid stimulating hormone (TSH) 546 475 $947.79
86900 1,035 847 $876.23
83605 364 271 $826.53
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 268 253 $752.90
87086 Culture, bacterial; quantitative colony count, urine 661 572 $727.32
J1170 Injection, hydromorphone, up to 4 mg 3,249 2,097 $715.94
77066 Tomosynthesis, mammo 13 13 $665.94
99153 Mod sedat endo service >5yrs 355 311 $565.23
J3010 Injection, fentanyl citrate, 0.1 mg 5,439 4,535 $517.14
95912 12 12 $469.74
83036 Hemoglobin; glycosylated (A1C) 137 127 $459.02
87081 213 203 $386.55
J2250 Injection, midazolam hydrochloride, per 1 mg 2,241 1,986 $379.54
99152 679 614 $349.92
J1885 Injection, ketorolac tromethamine, per 15 mg 2,861 2,254 $321.77
80143 104 87 $304.80
85730 314 266 $281.41
80179 107 88 $240.71
97116 25 12 $175.21
J0690 Injection, cefazolin sodium, 500 mg 2,936 2,124 $172.45
Q9957 Injection, perflutren lipid microspheres, per ml 16 12 $165.71
J2270 Injection, morphine sulfate, up to 10 mg 1,355 957 $164.69
84100 511 366 $161.94
80061 Lipid panel 35 26 $147.69
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 834 722 $137.15
J0696 Injection, ceftriaxone sodium, per 250 mg 536 377 $129.23
85379 30 26 $118.75
73562 27 24 $118.60
74018 29 24 $106.81
J2785 Injection, regadenoson, 0.1 mg 467 392 $80.68
J3490 Unclassified drugs 1,295 536 $74.19
76000 14 13 $53.83
J2370 Injection, phenylephrine hcl, up to 1 ml 905 672 $46.56
C1769 Guide wire 272 245 $40.52
J1200 Injection, diphenhydramine hcl, up to 50 mg 472 397 $38.06
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 12 12 $35.09
J1644 Injection, heparin sodium, per 1000 units 575 315 $25.89
J2550 Injection, promethazine hcl, up to 50 mg 254 182 $24.58
J1650 Injection, enoxaparin sodium, 10 mg 245 123 $23.93
85652 49 40 $17.04
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 248 191 $13.05
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 107 89 $8.51
J7050 Infusion, normal saline solution, 250 cc 92 50 $6.54
J2704 Injection, propofol, 10 mg 2,205 1,787 $6.16
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 87 64 $6.08
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 54 28 $5.50
87186 32 27 $3.87
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 328 293 $3.75
A9270 Non-covered item or service 7,786 1,556 $2.00
84703 12 12 $1.93
J0780 Injection, prochlorperazine, up to 10 mg 33 24 $1.32
29581 53 13 $0.00
J2795 Injection, ropivacaine hydrochloride, 1 mg 166 131 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 83 70 $0.00
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 14 12 $0.00
87077 13 12 $0.00
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 390 308 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 54 39 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 20 15 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 20 15 $0.00
J1171 Injection, hydromorphone, 0.1 mg 58 46 $0.00