Hospital
Prisma Health - Blount Memorial Hospital INC.
Prisma Health - Blount Memorial Hospital INC. was paid $14.75M by Medicaid between Jan 2018 and Nov 2024, across 98 billing codes. Its largest line is 99284, emergency room visit (serious) — 50% of everything it billed.
33Billing provider infoPRISMA HEALTH - BLOUNT MEMORIAL HOSPITAL INC.
MARYVILLE, TN 37804
MARYVILLE, TN 37804
33aNPI1619939071assigned 04/03/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$14.75M
24GClaims300,923
24DCodes billed98
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in Tennessee
Rank by total paid#19 of 71
Median peer was paid$6.96M
This provider vs. median2.1×
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 LAWRENCE, KRISTI 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 | 48,100 | $2.44M | |
| 2019 | 49,305 | $2.34M | |
| 2020 | 42,911 | $2.12M | |
| 2021 | 47,137 | $2.26M | |
| 2022 | 39,684 | $1.97M | |
| 2023 | 44,159 | $2.13M | |
| 2024incomplete | 29,627 | $1.49M |
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 | 50% | 36,166 | 34,044 | $7.38M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 24% | 23,486 | 22,495 | $3.49M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 5.5% | 7,499 | 7,277 | $810K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 3.8% | 2,229 | 2,066 | $563K |
| 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 | 2.7% | 6,469 | 6,080 | $405K |
| G0378 | Hospital observation service, per hour | 2.4% | 2,059 | 1,573 | $356K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 1.7% | 5,448 | 1,562 | $248K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.4% | 43,727 | 40,097 | $206K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 1.3% | 4,135 | 1,162 | $195K |
| 80053 | Comprehensive metabolic panel | <1% | 40,340 | 36,959 | $139K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 9,961 | 9,254 | $136K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 1,142 | 1,080 | $108K |
86 more codes
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 2,416 | $81K |
| 84484 | <1% | 6,122 | $63K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 2,172 | $55K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 12,078 | $45K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 8,060 | $39K |
| 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 | <1% | 1,029 | $27K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,356 | $26K |
| 84703 | <1% | 3,833 | $25K | |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 3,525 | $22K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,655 | $22K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 121 | $20K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 2,874 | $19K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 3,558 | $18K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 712 | $18K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 254 | $18K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 452 | $18K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,674 | $18K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,241 | $17K |
| 81001 | <1% | 19,081 | $17K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 530 | $16K |
| 87400 | <1% | 2,113 | $12K | |
| 87081 | <1% | 2,249 | $10K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 38 | $10K |
| 97597 | <1% | 390 | $9K | |
| 83690 | <1% | 1,811 | $9K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,933 | $9K |
| 71045 | Radiologic examination, chest; single view | <1% | 3,536 | $8K |
| 95811 | <1% | 57 | $7K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 293 | $7K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 13 | $5K |
| 85610 | <1% | 4,064 | $4K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,672 | $4K |
| 81025 | <1% | 1,419 | $4K | |
| 85730 | <1% | 1,316 | $4K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 94 | $4K |
| 83970 | <1% | 782 | $3K | |
| 83605 | <1% | 415 | $3K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 85 | $2K |
| 71250 | <1% | 93 | $2K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,389 | $2K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 677 | $1K |
| 95816 | <1% | 14 | $1K | |
| 82728 | <1% | 321 | $779.95 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 12 | $668.75 |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 15 | $635.74 |
| 94060 | <1% | 17 | $616.71 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 537 | $518.24 |
| 83550 | <1% | 296 | $475.03 | |
| 73630 | <1% | 47 | $468.87 | |
| 84702 | <1% | 23 | $440.91 | |
| 82607 | <1% | 220 | $378.42 | |
| 80069 | <1% | 525 | $370.81 | |
| 83540 | <1% | 296 | $345.17 | |
| G9162 | Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals | <1% | 75 | $334.56 |
| 94618 | <1% | 29 | $255.48 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 240 | $251.99 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 132 | $248.90 |
| 77300 | <1% | 25 | $240.60 | |
| 77334 | <1% | 16 | $232.78 | |
| 80061 | Lipid panel | <1% | 378 | $200.79 |
| 94729 | <1% | 29 | $198.76 | |
| 82746 | <1% | 122 | $168.86 | |
| 83735 | <1% | 38 | $132.64 | |
| 85027 | <1% | 15 | $119.72 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 15 | $95.28 |
| G9163 | Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting | <1% | 75 | $83.64 |
| 87077 | <1% | 43 | $62.56 | |
| 94727 | <1% | 17 | $56.91 | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 12 | $55.55 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 84 | $50.21 |
| 84481 | <1% | 53 | $48.65 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 4,327 | $35.26 |
| 84439 | <1% | 53 | $25.48 | |
| 81003 | <1% | 60 | $9.57 | |
| 87186 | <1% | 13 | $5.63 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 318 | $0.00 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 0% | 153 | $0.00 |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 0% | 927 | $0.00 |
| J0690 | Injection, cefazolin sodium, 500 mg | 0% | 19 | $0.00 |
| 88304 | 0% | 14 | $0.00 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 0% | 262 | $0.00 |
| A9576 | Injection, gadoteridol, (prohance multipack), per ml | 0% | 15 | $0.00 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 0% | 127 | $0.00 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 0% | 27 | $0.00 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 0% | 29 | $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 | 0% | 15 | $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 officialLAWRENCE, KRISTI (DIRECTOR PROVIDER ENROLLMENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.