Medicaid Provider Spending

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

MOUNTAIN STATES HEALTH ALLIANCE

NPI: 1497859789 · MOUNTAIN CITY, TN 37683 · Critical Access Hospital · NPI assigned 09/08/2006

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

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

$3.03M
Total Medicaid Paid
52,205
Total Claims
43,215
Beneficiaries
49
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date09/08/2006

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
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 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
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 8,591 $303K
2019 6,751 $302K
2020 3,319 $169K
2021 3,136 $293K
2022 7,577 $601K
2023 13,305 $724K
2024 9,526 $637K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 9,255 8,181 $1.49M
99283 Emergency department visit for the evaluation and management, moderate severity 7,723 7,197 $672K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 2,211 1,785 $416K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 2,889 2,538 $226K
80053 Comprehensive metabolic panel 5,514 4,431 $36K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 4,544 3,679 $25K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 662 626 $24K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 1,223 997 $20K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,375 666 $16K
99282 Emergency department visit for the evaluation and management, low to moderate severity 342 329 $15K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 1,512 1,066 $13K
36415 Collection of venous blood by venipuncture 6,621 4,988 $11K
84484 985 659 $10K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 181 152 $7K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 428 410 $5K
83735 995 751 $5K
71046 Radiologic examination, chest; 2 views 303 266 $4K
96375 Therapeutic injection; each additional sequential IV push 300 225 $4K
71045 Radiologic examination, chest; single view 421 326 $4K
85027 983 821 $4K
96361 Intravenous infusion, hydration; each additional hour 229 166 $3K
87077 382 360 $2K
81001 903 758 $2K
84443 Thyroid stimulating hormone (TSH) 249 211 $2K
80048 Basic metabolic panel (calcium, ionized) 257 203 $1K
70450 Computed tomography, head or brain; without contrast material 14 12 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 86 77 $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 14 12 $830.00
80061 Lipid panel 179 155 $804.81
83036 Hemoglobin; glycosylated (A1C) 417 336 $714.54
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 39 28 $686.40
83690 130 113 $671.49
J2405 Injection, ondansetron hydrochloride, per 1 mg 144 122 $560.27
82043 115 97 $539.57
81025 57 52 $317.80
74018 14 12 $244.82
82570 115 97 $183.14
83880 14 13 $168.92
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 17 14 $148.77
J1885 Injection, ketorolac tromethamine, per 15 mg 78 64 $143.04
81003 114 92 $141.44
87086 Culture, bacterial; quantitative colony count, urine 30 24 $137.29
87070 13 12 $127.94
83605 45 25 $122.16
87081 17 14 $110.83
94761 16 12 $83.16
94760 17 14 $33.84
J7030 Infusion, normal saline solution , 1000 cc 18 15 $31.36
J0696 Injection, ceftriaxone sodium, per 250 mg 15 12 $14.08