Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $3.03M by Medicaid between Jan 2018 and Nov 2024, across 49 billing codes. Its largest line is 99284, emergency room visit (serious) — 49% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
MOUNTAIN CITY, TN 37683
MOUNTAIN CITY, TN 37683
33aNPI1497859789assigned 09/08/2006
33bProvider typeCritical Access Hospital
28Total paid$3.03M
24GClaims52,205
24DCodes billed49
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Critical Access Hospital providers in Tennessee
Rank by total paid#6 of 15
Median peer was paid$1.48M
This provider vs. median2.0×
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 | |
|---|---|---|---|
| 2018 | 8,591 | $303K | |
| 2019 | 6,751 | $302K | |
| 2020 | 3,319 | $169K | |
| 2021 | 3,136 | $293K | |
| 2022 | 7,577 | $601K | |
| 2023 | 13,305 | $724K | |
| 2024incomplete | 9,526 | $637K |
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 | 49% | 9,255 | 8,181 | $1.49M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 22% | 7,723 | 7,197 | $672K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 14% | 2,211 | 1,785 | $416K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 7.5% | 2,889 | 2,538 | $226K |
| 80053 | Comprehensive metabolic panel | 1.2% | 5,514 | 4,431 | $36K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 4,544 | 3,679 | $25K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 662 | 626 | $24K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 1,223 | 997 | $20K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,375 | 666 | $16K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 342 | 329 | $15K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 1,512 | 1,066 | $13K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,621 | 4,988 | $11K |
37 more codes
| 84484 | <1% | 985 | $10K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 181 | $7K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 428 | $5K |
| 83735 | <1% | 995 | $5K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 303 | $4K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 300 | $4K |
| 71045 | Radiologic examination, chest; single view | <1% | 421 | $4K |
| 85027 | <1% | 983 | $4K | |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 229 | $3K |
| 87077 | <1% | 382 | $2K | |
| 81001 | <1% | 903 | $2K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 249 | $2K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 257 | $1K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 14 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 86 | $1K |
| 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% | 14 | $830.00 |
| 80061 | Lipid panel | <1% | 179 | $804.81 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 417 | $714.54 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 39 | $686.40 |
| 83690 | <1% | 130 | $671.49 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 144 | $560.27 |
| 82043 | <1% | 115 | $539.57 | |
| 81025 | <1% | 57 | $317.80 | |
| 74018 | <1% | 14 | $244.82 | |
| 82570 | <1% | 115 | $183.14 | |
| 83880 | <1% | 14 | $168.92 | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 17 | $148.77 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 78 | $143.04 |
| 81003 | <1% | 114 | $141.44 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 30 | $137.29 |
| 87070 | <1% | 13 | $127.94 | |
| 83605 | <1% | 45 | $122.16 | |
| 87081 | <1% | 17 | $110.83 | |
| 94761 | <1% | 16 | $83.16 | |
| 94760 | <1% | 17 | $33.84 | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 18 | $31.36 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 15 | $14.08 |
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.