Clinic
Monument Health Network, INC.
Monument Health Network, INC. was paid $1.82M by Medicaid between Jan 2018 and Dec 2024, across 58 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoMONUMENT HEALTH NETWORK, INC.
SPEARFISH, SD 57783
SPEARFISH, SD 57783
33aNPI1578942496assigned 05/26/2015
33bProvider typeMulti-Specialty Clinic/Center
28Total paid$1.82M
24GClaims64,733
24DCodes billed58
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Multi-Specialty Clinic/Center providers in South Dakota
Rank by total paid#4 of 24
Median peer was paid$251K
This provider vs. median7.2×
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 WORSLEY, THOMAS controls 13+ 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 | 8,657 | $199K | |
| 2019 | 9,390 | $232K | |
| 2020 | 5,774 | $144K | |
| 2021 | 8,872 | $278K | |
| 2022 | 9,691 | $294K | |
| 2023 | 10,938 | $294K | |
| 2024incomplete | 11,411 | $377K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 34% | 18,155 | 15,334 | $619K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 24% | 9,577 | 8,293 | $440K |
| W0037 | 7.9% | 3,870 | 3,870 | $144K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 4.6% | 785 | 746 | $83K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.4% | 1,057 | 958 | $62K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 3.3% | 1,327 | 1,259 | $60K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.2% | 2,470 | 2,269 | $58K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 2.4% | 1,726 | 1,339 | $44K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.7% | 1,031 | 927 | $30K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.5% | 1,614 | 900 | $27K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.5% | 448 | 387 | $27K |
| 80053 | Comprehensive metabolic panel | 1.4% | 2,579 | 2,319 | $25K |
46 more codes
| 36415 | Collection of venous blood by venipuncture | 1.4% | 5,622 | $25K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.3% | 1,694 | $23K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.2% | 3,026 | $22K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.0% | 1,857 | $19K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,054 | $18K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 671 | $11K |
| 11721 | <1% | 767 | $10K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 560 | $10K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 121 | $7K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 296 | $5K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 41 | $4K |
| 87807 | <1% | 282 | $4K | |
| 99335 | <1% | 158 | $4K | |
| 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% | 55 | $4K |
| 80061 | Lipid panel | <1% | 283 | $4K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 410 | $3K |
| 90686 | <1% | 520 | $3K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 285 | $3K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 45 | $2K |
| 81001 | <1% | 755 | $2K | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 535 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 30 | $1K |
| 98967 | <1% | 58 | $1K | |
| U0005 | 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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 56 | $1K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 32 | $1K |
| 99442 | <1% | 64 | $874.69 | |
| 73630 | <1% | 43 | $832.01 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 16 | $769.65 |
| 99348 | <1% | 37 | $741.69 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 12 | $691.68 |
| 90656 | <1% | 52 | $622.70 | |
| 90677 | <1% | 15 | $577.32 | |
| 98966 | <1% | 39 | $432.37 | |
| 81025 | <1% | 56 | $430.50 | |
| 90651 | <1% | 49 | $383.00 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 54 | $306.18 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 28 | $195.84 |
| 85027 | <1% | 28 | $155.28 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 42 | $153.31 |
| 90715 | <1% | 44 | $121.00 | |
| 81003 | <1% | 29 | $82.32 | |
| 83690 | <1% | 13 | $75.79 | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 0% | 199 | $0.00 |
| 90734 | 0% | 34 | $0.00 | |
| 91301 | 0% | 15 | $0.00 | |
| 90723 | 0% | 12 | $0.00 |
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 officialWORSLEY, THOMAS (PRESIDENT SPEARFISH HOSPITAL)
| Provider | Location | Paid |
|---|---|---|
| Monument Health Network, INC. | Spearfish, SD | $2.02M |
| Monument Health Network, INC. | Belle Fourche, SD | $879K |
| Monument Health Network, INC. | Spearfish, SD | $743K |
| Monument Health Network, INC. | Spearfish, SD | $441K |
| Monument Health Network, INC. | Spearfish, SD | $220K |
| Monument Health Network, INC. | Spearfish, SD | $101K |
| Monument Health Network, INC. | Newcastle, WY | $94K |
| Monument Health Network, INC. | Spearfish, SD | $18K |
| Monument Health Network, INC. | Spearfish, SD | $15K |
| Monument Health Network, INC. | Belle Fourche, SD | $14K |
| Monument Health Network, INC. | Spearfish, SD | $8K |
| Monument Health Network, INC. | Spearfish, SD | $2K |
| Monument Health Network, INC. | Buffalo, SD | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.