Medicaid Provider Spending

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

WELLMONT MEDICAL ASSOCIATES INC

NPI: 1780986257 · KINGSPORT, TN 37660 · Family Medicine Physician · NPI assigned 12/03/2010

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

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

$27.84M
Total Medicaid Paid
1,150,521
Total Claims
911,737
Beneficiaries
199
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date12/03/2010

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 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
MOUNTAIN STATES HEALTH ALLIANCE MOUNTAIN CITY TN $3.03M
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 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
2024 185,984 $5.05M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 194,012 159,894 $8.24M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 217,631 186,436 $7.62M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 21,252 18,232 $2.44M
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 34,191 29,634 $1.08M
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 25,663 22,304 $1.06M
99232 Subsequent hospital care, per day, moderate complexity 47,298 16,501 $942K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 10,813 8,392 $846K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 12,965 11,350 $715K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 43,343 19,629 $512K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 5,742 4,890 $376K
99233 Prolong inpt eval add15 m 12,573 4,523 $300K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 25,975 23,230 $262K
99223 Prolong inpt eval add15 m 4,375 3,637 $219K
99215 Prolong outpt/office vis 3,680 2,780 $193K
99309 Subsequent nursing facility care, per day, low to moderate complexity 25,214 12,618 $189K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 13,327 10,881 $159K
99222 Initial hospital care, per day, moderate complexity 2,708 2,311 $122K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 9,966 8,786 $121K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,927 4,431 $116K
95810 Polysomnography; sleep staging with 4 or more additional parameters 1,187 1,048 $100K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 2,459 2,143 $95K
99239 Hospital discharge day management, more than 30 minutes 3,420 2,820 $95K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1,039 380 $84K
76830 Ultrasound, transvaginal 1,386 1,070 $83K
90837 Psychotherapy, 53 minutes with patient 864 475 $79K
3074F 87,529 76,855 $72K
3078F 79,163 70,028 $69K
95886 2,138 1,563 $69K
71046 Radiologic examination, chest; 2 views 4,423 3,930 $67K
90460 Immunization administration through 18 years of age via any route, first or only component 3,735 3,181 $65K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 817 714 $54K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 940 610 $53K
76819 Fetal biophysical profile; without non-stress testing 988 382 $52K
99231 Subsequent hospital care, per day, straightforward or low complexity 3,525 1,547 $50K
99443 2,958 2,233 $49K
36415 Collection of venous blood by venipuncture 44,738 36,129 $48K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 652 593 $46K
95811 674 585 $45K
95806 1,377 1,182 $45K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 10,432 8,537 $43K
J1050 Injection, medroxyprogesterone acetate, 1 mg 652 564 $42K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 633 548 $42K
90834 Psychotherapy, 45 minutes with patient 707 414 $41K
94729 2,494 2,045 $39K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 548 493 $35K
90853 Group psychotherapy (other than of a multiple-family group) 1,377 462 $31K
83036 Hemoglobin; glycosylated (A1C) 11,317 9,472 $29K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 2,082 1,651 $26K
99441 1,298 1,060 $23K
97597 2,720 1,352 $23K
80061 Lipid panel 7,721 6,359 $22K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 431 348 $21K
80305 3,575 1,164 $19K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 340 303 $19K
94726 1,197 994 $19K
80050 General health panel 1,390 1,244 $18K
81003 11,721 10,234 $18K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,364 463 $18K
99442 1,526 1,120 $17K
87634 342 264 $17K
90686 1,976 1,714 $17K
80053 Comprehensive metabolic panel 9,154 7,490 $17K
99238 Hospital discharge day management, 30 minutes or less 743 623 $16K
99308 Subsequent nursing facility care, per day, straightforward 2,519 1,683 $15K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 166 157 $15K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 195 163 $15K
95911 212 181 $14K
90792 Psychiatric diagnostic evaluation with medical services 198 144 $14K
3077F 10,236 9,220 $14K
82962 8,651 7,193 $13K
96367 388 235 $12K
27096 198 169 $12K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 254 202 $11K
3075F 9,929 9,069 $10K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 185 145 $10K
90791 Psychiatric diagnostic evaluation 108 81 $10K
3079F 12,776 11,853 $9K
81025 1,840 1,577 $9K
94010 1,323 1,088 $9K
95251 484 374 $8K
62323 170 141 $8K
64635 93 50 $7K
99221 252 199 $7K
94060 443 364 $7K
64493 175 91 $7K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 2,031 1,560 $7K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 741 651 $6K
87807 571 528 $6K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 6,675 5,752 $5K
95816 224 193 $5K
J2469 Injection, palonosetron hcl, 25 mcg 54 39 $5K
99205 Prolong outpt/office vis 84 65 $5K
95912 50 50 $5K
20610 192 133 $5K
95913 34 25 $5K
4010F 9,047 7,589 $5K
95909 94 82 $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) 767 657 $4K
36416 5,899 5,077 $4K
64494 197 91 $4K
3080F 2,424 2,201 $3K
94727 273 232 $3K
84443 Thyroid stimulating hormone (TSH) 1,432 1,226 $3K
90674 256 209 $3K
96417 78 52 $3K
73630 167 155 $3K
64636 93 49 $3K
73610 159 139 $3K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 405 328 $2K
96375 Therapeutic injection; each additional sequential IV push 196 143 $2K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 1,689 1,293 $2K
90832 Psychotherapy, 30 minutes with patient 50 38 $2K
20553 60 55 $2K
85027 697 570 $2K
73130 106 97 $2K
94618 140 112 $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) 213 174 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 1,496 1,262 $2K
82607 513 399 $2K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 339 259 $2K
59025 Fetal non-stress test 77 64 $2K
99406 336 280 $2K
G0426 Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth 120 71 $1K
82044 306 260 $1K
0352U 61 45 $1K
0502F 13,128 7,903 $1K
99305 90 76 $1K
99307 249 97 $1K
J0696 Injection, ceftriaxone sodium, per 250 mg 830 670 $1K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 251 222 $1K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 55 36 $1K
96127 309 259 $1K
64495 43 25 $915.14
G0407 Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth 18 14 $908.67
90461 1,154 959 $896.32
99401 116 56 $823.30
94760 2,071 1,713 $815.95
73560 77 56 $811.53
73110 48 40 $785.98
82570 286 244 $768.91
J1010 Injection, methylprednisolone acetate, 1 mg 17 12 $731.66
31624 24 12 $697.62
90670 54 50 $687.13
99383 16 12 $625.16
99219 15 12 $564.76
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 32 25 $559.37
3044F 344 300 $550.00
84439 321 272 $549.95
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 32 25 $539.77
95910 16 13 $537.64
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 25 15 $490.59
82465 279 237 $460.31
82728 161 121 $445.19
J2780 Injection, ranitidine hydrochloride, 25 mg 96 50 $443.85
81002 200 172 $409.62
95819 13 12 $391.56
99282 Emergency department visit for the evaluation and management, low to moderate severity 82 55 $382.98
99217 17 13 $371.09
83550 188 148 $369.16
99000 2,512 2,174 $357.53
99356 15 12 $346.75
83540 188 150 $272.37
99188 13 12 $261.96
G0425 Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth 52 33 $252.51
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 13 12 $219.23
86308 43 42 $208.98
81001 261 181 $203.92
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 419 309 $201.36
80048 Basic metabolic panel (calcium, ionized) 102 93 $197.37
72100 16 12 $197.35
99459 18 13 $178.07
3046F 96 77 $170.00
73030 16 12 $147.96
J1040 Injection, methylprednisolone acetate, 80 mg 41 32 $139.13
90648 53 49 $132.12
86156 65 55 $105.02
82950 24 24 $98.54
J1030 Injection, methylprednisolone acetate, 40 mg 17 15 $96.87
82565 18 13 $85.23
84481 15 12 $68.22
G0444 Annual depression screening, 5 to 15 minutes 128 71 $62.96
83615 19 13 $55.28
0501F 54 53 $50.00
0503F 34 30 $50.00
84460 19 13 $48.55
84450 19 13 $47.42
84550 19 13 $41.41
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 14 14 $29.76
85018 12 12 $27.47
G0008 Administration of influenza virus vaccine 583 478 $20.03
G0406 Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth 26 12 $15.52
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 110 104 $9.07
J7644 Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram 42 39 $5.79
90651 27 24 $0.00
90656 23 16 $0.00
90662 85 68 $0.00
96160 57 37 $0.00
3051F 35 27 $0.00
90734 13 13 $0.00