Clinic
Monument Health Network, INC.
Monument Health Network, INC. was paid $879K by Medicaid between Jan 2018 and Dec 2024, across 21 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 52% of everything it billed.
33Billing provider infoMONUMENT HEALTH NETWORK, INC.
BELLE FOURCHE, SD 57717
BELLE FOURCHE, SD 57717
33aNPI1598144719assigned 05/20/2015
33bProvider typeRural Health Clinic/Center
28Total paid$879K
24GClaims14,768
24DCodes billed21
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in South Dakota
Rank by total paid#7 of 42
Median peer was paid$131K
This provider vs. median6.7×
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 | 2,483 | $194K | |
| 2019 | 2,336 | $205K | |
| 2020 | 1,206 | $74K | |
| 2021 | 2,496 | $121K | |
| 2022 | 1,666 | $101K | |
| 2023 | 2,315 | $78K | |
| 2024incomplete | 2,266 | $105K |
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 | 52% | 5,452 | 4,674 | $460K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 10% | 1,098 | 989 | $90K |
| 36415 | Collection of venous blood by venipuncture | 9.7% | 2,156 | 1,762 | $86K |
| 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 | 8.7% | 910 | 808 | $76K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 5.7% | 490 | 437 | $50K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.3% | 621 | 493 | $29K |
| 80053 | Comprehensive metabolic panel | 2.5% | 488 | 412 | $22K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.2% | 195 | 190 | $19K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.7% | 351 | 334 | $15K |
| W0037 | 1.1% | 2,269 | 2,269 | $9K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.0% | 146 | 78 | $9K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 32 | 30 | $3K |
9 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 35 | $3K |
| 90686 | <1% | 108 | $2K | |
| 81001 | <1% | 56 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 57 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 14 | $578.05 |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 0% | 247 | $0.00 |
| 90651 | 0% | 16 | $0.00 | |
| 90734 | 0% | 14 | $0.00 | |
| 90715 | 0% | 13 | $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. | Spearfish, SD | $1.82M |
| 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.