Physician
Wellmont Medical Associates INC
Wellmont Medical Associates INC was paid $27.84M by Medicaid between Jan 2018 and Dec 2024, across 199 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 30% of everything it billed.
33Billing provider infoWELLMONT MEDICAL ASSOCIATES INC
KINGSPORT, TN 37660
KINGSPORT, TN 37660
33aNPI1780986257assigned 12/03/2010
33bProvider typeFamily Medicine Physician
28Total paid$27.84M
24GClaims1,150,521
24DCodes billed199
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Tennessee
Rank by total paid#4 of 754
Median peer was paid$34K
This provider vs. median825×
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 | 127,301 | $2.79M | |
| 2019 | 156,287 | $3.75M | |
| 2020 | 123,498 | $2.90M | |
| 2021 | 135,708 | $4.40M | |
| 2022 | 209,348 | $4.46M | |
| 2023 | 212,395 | $4.49M | |
| 2024incomplete | 185,984 | $5.05M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 30% | 194,012 | 159,894 | $8.24M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 27% | 217,631 | 186,436 | $7.62M |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 8.8% | 21,252 | 18,232 | $2.44M |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 3.9% | 34,191 | 29,634 | $1.08M |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.8% | 25,663 | 22,304 | $1.06M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.4% | 47,298 | 16,501 | $942K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 3.0% | 10,813 | 8,392 | $846K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.6% | 12,965 | 11,350 | $715K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.8% | 43,343 | 19,629 | $512K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.3% | 5,742 | 4,890 | $376K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.1% | 12,573 | 4,523 | $300K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 25,975 | 23,230 | $262K |
187 more codes
| 99223 | Prolong inpt eval add15 m | <1% | 4,375 | $219K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 3,680 | $193K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 25,214 | $189K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 13,327 | $159K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 2,708 | $122K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 9,966 | $121K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,927 | $116K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 1,187 | $100K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 2,459 | $95K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 3,420 | $95K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 1,039 | $84K |
| 76830 | Ultrasound, transvaginal | <1% | 1,386 | $83K |
| 90837 | Psychotherapy session, about an hour | <1% | 864 | $79K |
| 3074F | <1% | 87,529 | $72K | |
| 3078F | <1% | 79,163 | $69K | |
| 95886 | <1% | 2,138 | $69K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 4,423 | $67K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 3,735 | $65K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 817 | $54K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 940 | $53K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 988 | $52K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 3,525 | $50K |
| 99443 | <1% | 2,958 | $49K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 44,738 | $48K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 652 | $46K |
| 95811 | <1% | 674 | $45K | |
| 95806 | <1% | 1,377 | $45K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 10,432 | $43K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 652 | $42K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 633 | $42K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 707 | $41K |
| 94729 | <1% | 2,494 | $39K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 548 | $35K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 1,377 | $31K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 11,317 | $29K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 2,082 | $26K |
| 99441 | <1% | 1,298 | $23K | |
| 97597 | <1% | 2,720 | $23K | |
| 80061 | Lipid panel | <1% | 7,721 | $22K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 431 | $21K |
| 80305 | <1% | 3,575 | $19K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 340 | $19K |
| 94726 | <1% | 1,197 | $19K | |
| 80050 | General health panel | <1% | 1,390 | $18K |
| 81003 | <1% | 11,721 | $18K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 1,364 | $18K |
| 99442 | <1% | 1,526 | $17K | |
| 87634 | <1% | 342 | $17K | |
| 90686 | <1% | 1,976 | $17K | |
| 80053 | Comprehensive metabolic panel | <1% | 9,154 | $17K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 743 | $16K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 2,519 | $15K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 166 | $15K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 195 | $15K |
| 95911 | <1% | 212 | $14K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 198 | $14K |
| 3077F | <1% | 10,236 | $14K | |
| 82962 | <1% | 8,651 | $13K | |
| 96367 | <1% | 388 | $12K | |
| 27096 | <1% | 198 | $12K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 254 | $11K |
| 3075F | <1% | 9,929 | $10K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 185 | $10K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 108 | $10K |
| 3079F | <1% | 12,776 | $9K | |
| 81025 | <1% | 1,840 | $9K | |
| 94010 | <1% | 1,323 | $9K | |
| 95251 | <1% | 484 | $8K | |
| 62323 | <1% | 170 | $8K | |
| 64635 | <1% | 93 | $7K | |
| 99221 | <1% | 252 | $7K | |
| 94060 | <1% | 443 | $7K | |
| 64493 | <1% | 175 | $7K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 2,031 | $7K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 741 | $6K |
| 87807 | <1% | 571 | $6K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 6,675 | $5K |
| 95816 | <1% | 224 | $5K | |
| J2469 | Injection, palonosetron hcl, 25 mcg | <1% | 54 | $5K |
| 99205 | Prolong outpt/office vis | <1% | 84 | $5K |
| 95912 | <1% | 50 | $5K | |
| 20610 | <1% | 192 | $5K | |
| 95913 | <1% | 34 | $5K | |
| 4010F | <1% | 9,047 | $5K | |
| 95909 | <1% | 94 | $4K | |
| 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% | 767 | $4K |
| 36416 | <1% | 5,899 | $4K | |
| 64494 | <1% | 197 | $4K | |
| 3080F | <1% | 2,424 | $3K | |
| 94727 | <1% | 273 | $3K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,432 | $3K |
| 90674 | <1% | 256 | $3K | |
| 96417 | <1% | 78 | $3K | |
| 73630 | <1% | 167 | $3K | |
| 64636 | <1% | 93 | $3K | |
| 73610 | <1% | 159 | $3K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 405 | $2K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 196 | $2K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 1,689 | $2K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 50 | $2K |
| 20553 | <1% | 60 | $2K | |
| 85027 | <1% | 697 | $2K | |
| 73130 | <1% | 106 | $2K | |
| 94618 | <1% | 140 | $2K | |
| G0296 | Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) | <1% | 213 | $2K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,496 | $2K |
| 82607 | <1% | 513 | $2K | |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 339 | $2K |
| 59025 | Fetal non-stress test | <1% | 77 | $2K |
| 99406 | <1% | 336 | $2K | |
| G0426 | Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth | <1% | 120 | $1K |
| 82044 | <1% | 306 | $1K | |
| 0352U | <1% | 61 | $1K | |
| 0502F | <1% | 13,128 | $1K | |
| 99305 | <1% | 90 | $1K | |
| 99307 | <1% | 249 | $1K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 830 | $1K |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 251 | $1K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 55 | $1K |
| 96127 | <1% | 309 | $1K | |
| 64495 | <1% | 43 | $915.14 | |
| G0407 | Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth | <1% | 18 | $908.67 |
| 90461 | <1% | 1,154 | $896.32 | |
| 99401 | <1% | 116 | $823.30 | |
| 94760 | <1% | 2,071 | $815.95 | |
| 73560 | <1% | 77 | $811.53 | |
| 73110 | <1% | 48 | $785.98 | |
| 82570 | <1% | 286 | $768.91 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 17 | $731.66 |
| 31624 | <1% | 24 | $697.62 | |
| 90670 | <1% | 54 | $687.13 | |
| 99383 | <1% | 16 | $625.16 | |
| 99219 | <1% | 15 | $564.76 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 32 | $559.37 |
| 3044F | <1% | 344 | $550.00 | |
| 84439 | <1% | 321 | $549.95 | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 32 | $539.77 |
| 95910 | <1% | 16 | $537.64 | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 25 | $490.59 |
| 82465 | <1% | 279 | $460.31 | |
| 82728 | <1% | 161 | $445.19 | |
| J2780 | Injection, ranitidine hydrochloride, 25 mg | <1% | 96 | $443.85 |
| 81002 | <1% | 200 | $409.62 | |
| 95819 | <1% | 13 | $391.56 | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 82 | $382.98 |
| 99217 | <1% | 17 | $371.09 | |
| 83550 | <1% | 188 | $369.16 | |
| 99000 | <1% | 2,512 | $357.53 | |
| 99356 | <1% | 15 | $346.75 | |
| 83540 | <1% | 188 | $272.37 | |
| 99188 | <1% | 13 | $261.96 | |
| G0425 | Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth | <1% | 52 | $252.51 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 13 | $219.23 |
| 86308 | <1% | 43 | $208.98 | |
| 81001 | <1% | 261 | $203.92 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 419 | $201.36 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 102 | $197.37 |
| 72100 | <1% | 16 | $197.35 | |
| 99459 | <1% | 18 | $178.07 | |
| 3046F | <1% | 96 | $170.00 | |
| 73030 | <1% | 16 | $147.96 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 41 | $139.13 |
| 90648 | <1% | 53 | $132.12 | |
| 86156 | <1% | 65 | $105.02 | |
| 82950 | <1% | 24 | $98.54 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 17 | $96.87 |
| 82565 | <1% | 18 | $85.23 | |
| 84481 | <1% | 15 | $68.22 | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 128 | $62.96 |
| 83615 | <1% | 19 | $55.28 | |
| 0501F | <1% | 54 | $50.00 | |
| 0503F | <1% | 34 | $50.00 | |
| 84460 | <1% | 19 | $48.55 | |
| 84450 | <1% | 19 | $47.42 | |
| 84550 | <1% | 19 | $41.41 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 14 | $29.76 |
| 85018 | <1% | 12 | $27.47 | |
| G0008 | Administration of influenza virus vaccine | <1% | 583 | $20.03 |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | <1% | 26 | $15.52 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 110 | $9.07 |
| J7644 | Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram | <1% | 42 | $5.79 |
| 90651 | 0% | 27 | $0.00 | |
| 90656 | 0% | 23 | $0.00 | |
| 90662 | 0% | 85 | $0.00 | |
| 96160 | 0% | 57 | $0.00 | |
| 3051F | 0% | 35 | $0.00 | |
| 90734 | 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 officialHILTON, SHANE (EVP/CFO)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.