Medicaid Provider Spending

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

WELLMONT HEALTH SYSTEM

NPI: 1801826912 · BIG STONE GAP, VA 24219 · General Acute Care Hospital · NPI assigned 07/04/2006

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

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

$33.71M
Total Medicaid Paid
893,633
Total Claims
696,211
Beneficiaries
328
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date07/04/2006

Related Entities

Other providers sharing the same authorized official: HILTON, SHANE

ProviderCityStateTotal Paid
JOHNSTON MEMORIAL HOSPITAL, INC ABINGDON VA $35.91M
MOUNTAIN STATES HEALTH ALLIANCE JOHNSON CITY TN $31.31M
WELLMONT MEDICAL ASSOCIATES INC KINGSPORT TN $27.84M
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 100,763 $2.40M
2019 125,379 $3.20M
2020 59,656 $2.09M
2021 172,830 $6.07M
2022 158,107 $6.29M
2023 164,208 $7.49M
2024 112,690 $6.17M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 39,312 33,666 $6.36M
99283 Emergency department visit for the evaluation and management, moderate severity 24,763 21,287 $3.28M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 20,578 17,297 $2.98M
96361 Intravenous infusion, hydration; each additional hour 10,266 7,932 $2.64M
74177 Computed tomography, abdomen and pelvis; with contrast material 6,702 5,930 $1.31M
70450 Computed tomography, head or brain; without contrast material 6,697 5,740 $1.06M
99282 Emergency department visit for the evaluation and management, low to moderate severity 7,980 7,200 $970K
74176 Computed tomography, abdomen and pelvis; without contrast material 4,215 3,700 $836K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 14,526 12,955 $797K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 3,299 2,197 $726K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 2,456 2,198 $704K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 5,969 3,019 $687K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 16,032 3,695 $626K
64493 624 510 $530K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 6,691 4,919 $529K
G0378 Hospital observation service, per hour 3,868 2,832 $470K
62323 940 831 $424K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 9,877 8,158 $416K
64635 336 248 $356K
27096 523 506 $323K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,742 1,617 $294K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 2,700 2,300 $289K
78815 Positron emission tomography (PET) for limited area imaging 360 326 $273K
71275 Computed tomographic angiography, chest, with contrast material 1,236 1,118 $266K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 594 540 $250K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 5,121 3,844 $223K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 2,704 1,953 $222K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1,076 920 $220K
J2505 Injection, pegfilgrastim, 6 mg 114 64 $205K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,924 1,766 $182K
77067 Screening mammography, bilateral, including computer-aided detection 3,618 3,454 $176K
80053 Comprehensive metabolic panel 42,557 34,258 $173K
76536 1,635 1,513 $160K
97162 1,638 1,470 $152K
96415 992 583 $151K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 785 737 $150K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 475 447 $143K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,773 1,547 $132K
99281 Emergency department visit for the evaluation and management, self-limited or minor 1,462 1,299 $132K
71046 Radiologic examination, chest; 2 views 8,303 7,440 $118K
J2469 Injection, palonosetron hcl, 25 mcg 1,813 911 $117K
J9271 Injection, pembrolizumab, 1 mg 15 14 $113K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 244 215 $113K
76700 Ultrasound, abdominal, real time with image documentation; complete 970 900 $108K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 109 105 $93K
93971 1,050 917 $91K
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care 5,747 1,518 $90K
95886 723 695 $89K
71250 1,610 1,409 $88K
96523 1,761 1,448 $86K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 542 515 $77K
72141 422 401 $77K
P9016 Red blood cells, leukocytes reduced, each unit 274 177 $72K
77412 392 36 $71K
36591 2,506 1,899 $68K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 351 76 $66K
29581 450 145 $66K
12001 350 319 $65K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 681 515 $61K
76641 530 472 $55K
87040 9,478 4,645 $53K
J1439 Injection, ferric carboxymaltose, 1 mg 465 240 $52K
J1453 Injection, fosaprepitant, 1 mg 650 348 $51K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 22,468 17,341 $48K
0202U Oncology (prostate), multianalyte, gene expression profiling 632 602 $48K
73221 278 253 $47K
84443 Thyroid stimulating hormone (TSH) 8,166 7,374 $47K
74018 2,833 2,550 $47K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 47,721 37,268 $46K
83880 5,963 4,871 $46K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 20,052 16,242 $45K
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 5,161 4,247 $44K
72125 Computed tomography, cervical spine; without contrast material 2,051 1,789 $44K
J0897 Injection, denosumab, 1 mg 104 95 $43K
36415 Collection of venous blood by venipuncture 38,241 28,607 $43K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 13,640 11,850 $43K
73562 2,944 2,598 $42K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 14,111 10,697 $42K
80048 Basic metabolic panel (calcium, ionized) 11,322 8,716 $41K
47562 12 12 $41K
72100 2,195 2,007 $38K
95810 Polysomnography; sleep staging with 4 or more additional parameters 70 65 $37K
36430 397 246 $34K
71271 358 350 $34K
77336 653 244 $33K
95811 75 69 $33K
93017 337 305 $29K
71045 Radiologic examination, chest; single view 14,980 12,381 $28K
73030 2,336 2,041 $28K
73630 2,725 2,448 $25K
73610 2,242 2,050 $22K
90715 1,160 1,076 $21K
70551 Magnetic resonance imaging, brain; without contrast material 111 101 $21K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,501 1,414 $20K
70496 74 64 $19K
97530 Therapeutic activities, direct patient contact, each 15 minutes 599 171 $18K
84484 17,432 11,994 $18K
83036 Hemoglobin; glycosylated (A1C) 3,944 3,658 $17K
95806 25 24 $17K
80061 Lipid panel 3,307 3,042 $16K
70486 401 350 $16K
73130 1,920 1,723 $16K
97014 513 170 $14K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 883 253 $14K
87086 Culture, bacterial; quantitative colony count, urine 7,691 6,655 $13K
96416 43 24 $13K
85379 3,048 2,682 $13K
59025 Fetal non-stress test 66 54 $13K
85027 5,730 4,760 $13K
J7030 Infusion, normal saline solution , 1000 cc 6,827 5,248 $12K
97035 544 149 $12K
73502 1,154 994 $12K
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 803 699 $12K
72131 301 273 $12K
45380 Colonoscopy, flexible; with biopsy, single or multiple 12 12 $12K
80074 940 883 $12K
97597 113 78 $11K
74178 54 49 $11K
73110 1,265 1,141 $11K
96375 Therapeutic injection; each additional sequential IV push 16,411 11,610 $11K
84702 2,142 1,678 $11K
29125 58 52 $10K
64494 640 507 $10K
62321 12 12 $10K
84439 2,574 2,355 $10K
81001 18,403 15,340 $9K
70491 59 53 $9K
81025 9,203 8,105 $9K
97161 52 52 $8K
94729 301 286 $8K
84481 691 647 $8K
64636 38 24 $8K
83605 10,201 7,491 $8K
0001A 279 254 $7K
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography 30 27 $7K
76830 Ultrasound, transvaginal 70 67 $7K
86592 1,125 1,052 $7K
93970 73 65 $7K
72040 225 210 $7K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 1,166 1,107 $7K
81003 11,791 10,203 $7K
0002A 215 196 $7K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 75 65 $6K
93246 168 164 $6K
82670 443 423 $6K
96417 818 412 $6K
87186 3,609 3,072 $5K
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 42 37 $5K
94726 137 129 $5K
82607 979 920 $5K
76000 153 134 $5K
72110 124 115 $5K
84403 393 373 $4K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 968 826 $4K
94060 87 81 $4K
83001 511 489 $4K
84146 481 454 $4K
72050 160 151 $4K
73080 539 472 $4K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 42 41 $4K
J7050 Infusion, normal saline solution, 250 cc 3,230 1,415 $4K
80143 1,104 932 $4K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 484 448 $4K
83002 506 484 $4K
97163 90 83 $4K
77080 59 59 $4K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 8,613 4,369 $4K
86850 1,956 1,626 $4K
95913 66 63 $4K
29515 13 13 $3K
86901 2,339 1,940 $3K
96376 4,729 3,078 $3K
J2405 Injection, ondansetron hydrochloride, per 1 mg 13,339 10,572 $3K
36600 2,567 1,951 $3K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,275 1,120 $3K
96367 3,451 1,883 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 201 186 $3K
82728 450 408 $3K
83735 9,926 7,923 $3K
A9585 Injection, gadobutrol, 0.1 ml 1,465 1,330 $3K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 8,724 6,459 $3K
83655 226 223 $3K
72072 185 166 $3K
74174 12 12 $2K
82565 1,308 1,098 $2K
87077 3,448 2,938 $2K
87070 1,583 1,310 $2K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 16 13 $2K
86762 347 324 $2K
12002 12 12 $2K
86140 1,188 1,055 $2K
80076 740 637 $2K
73590 343 308 $2K
10060 44 37 $2K
93880 30 25 $2K
82570 731 645 $2K
76870 16 14 $2K
J8540 Dexamethasone, oral, 0.25 mg 1,750 842 $2K
83525 282 268 $2K
87081 5,552 5,094 $2K
85018 538 457 $2K
74022 523 467 $2K
80179 1,063 913 $2K
85652 1,445 1,257 $2K
85610 3,624 2,925 $2K
82950 376 365 $2K
83690 11,231 9,405 $2K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 8,494 4,224 $2K
86900 2,330 1,929 $2K
95910 12 12 $2K
77280 16 13 $2K
83550 328 302 $2K
83540 495 455 $1K
93242 26 25 $1K
J1885 Injection, ketorolac tromethamine, per 15 mg 10,266 8,495 $1K
94664 1,081 850 $1K
70498 46 38 $1K
71101 141 122 $965.47
82140 1,454 1,164 $951.94
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 483 447 $912.53
83050 623 505 $904.38
87205 1,435 1,118 $904.21
64495 128 106 $852.53
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 3,584 3,348 $785.73
95912 14 14 $781.80
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,326 1,175 $772.21
84703 2,898 2,615 $756.16
82803 2,061 1,477 $721.58
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 5,845 5,358 $720.66
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 1,768 1,135 $671.60
77065 Tomosynthesis, mammo 14 12 $651.48
84100 1,202 907 $618.11
73090 158 137 $609.93
82043 292 267 $584.61
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 2,556 1,999 $579.42
85730 1,751 1,474 $577.57
J0696 Injection, ceftriaxone sodium, per 250 mg 5,540 4,277 $569.99
J2270 Injection, morphine sulfate, up to 10 mg 3,465 2,561 $550.54
72128 28 25 $527.53
J1200 Injection, diphenhydramine hcl, up to 50 mg 3,712 2,726 $513.68
84520 414 338 $512.61
88305 Level IV - Surgical pathology, gross and microscopic examination 1,570 1,422 $505.29
94727 29 25 $503.07
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 32 28 $480.90
77066 Tomosynthesis, mammo 16 12 $470.68
82166 26 24 $469.49
85007 1,756 1,438 $413.96
J3480 Injection, potassium chloride, per 2 meq 1,161 655 $409.80
J2250 Injection, midazolam hydrochloride, per 1 mg 3,559 3,086 $398.26
J2060 Injection, lorazepam, 2 mg 1,035 779 $347.03
84156 143 118 $341.09
J2360 Injection, orphenadrine citrate, up to 60 mg 1,421 1,238 $320.72
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,140 806 $311.03
J3490 Unclassified drugs 2,340 1,394 $291.93
84112 18 15 $280.24
84550 205 179 $279.49
82550 563 476 $275.21
C9113 Injection, pantoprazole sodium, per vial 1,566 1,051 $274.48
82150 1,419 1,226 $253.52
J0690 Injection, cefazolin sodium, 500 mg 1,708 1,448 $251.37
J1756 Injection, iron sucrose, 1 mg 475 181 $251.02
J3010 Injection, fentanyl citrate, 0.1 mg 4,279 3,456 $249.28
94761 3,667 2,748 $234.25
94762 43 31 $232.72
87641 91 83 $221.20
J1170 Injection, hydromorphone, up to 4 mg 1,999 1,423 $220.05
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 1,111 913 $205.82
J1940 Injection, furosemide, up to 20 mg 562 349 $205.74
82805 615 497 $195.80
J1030 Injection, methylprednisolone acetate, 40 mg 468 417 $185.27
J1650 Injection, enoxaparin sodium, 10 mg 1,041 661 $184.11
J7120 Ringers lactate infusion, up to 1000 cc 1,882 1,505 $179.69
96368 634 396 $175.29
0011A 29 25 $158.57
J3475 Injection, magnesium sulfate, per 500 mg 1,206 838 $143.10
80320 272 239 $127.34
51702 14 12 $117.95
82272 314 274 $111.30
J0780 Injection, prochlorperazine, up to 10 mg 1,371 1,156 $102.22
J3370 Injection, vancomycin hcl, 500 mg 717 340 $96.31
87209 15 15 $95.43
J2785 Injection, regadenoson, 0.1 mg 168 144 $93.26
73552 17 14 $85.78
86038 14 12 $82.79
94760 1,770 1,386 $81.28
82375 617 500 $79.34
87210 57 55 $73.80
87807 468 443 $71.87
J9190 Injection, fluorouracil, 500 mg 119 24 $71.16
J2765 Injection, metoclopramide hcl, up to 10 mg 908 776 $62.60
87177 15 15 $58.20
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 48 39 $57.28
J1644 Injection, heparin sodium, per 1000 units 348 205 $55.01
J1815 Injection, insulin, per 5 units 756 361 $47.36
J2550 Injection, promethazine hcl, up to 50 mg 565 443 $39.95
J2780 Injection, ranitidine hydrochloride, 25 mg 259 88 $32.12
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 609 216 $31.75
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 259 223 $26.37
J2704 Injection, propofol, 10 mg 3,310 2,887 $25.90
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 757 658 $22.43
J2471 Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg 108 86 $19.58
82010 117 95 $17.99
86308 59 54 $16.31
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 265 115 $15.80
88312 468 433 $14.24
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 247 217 $6.77
J2175 Injection, meperidine hydrochloride, per 100 mg 185 128 $6.63
J0171 Injection, adrenalin, epinephrine, 0.1 mg 80 54 $5.90
J7510 Prednisolone oral, per 5 mg 79 75 $4.99
J1020 Injection, methylprednisolone acetate, 20 mg 69 57 $2.74
88304 308 283 $1.97
J0456 Injection, azithromycin, 500 mg 31 24 $1.58
J1956 Injection, levofloxacin, 250 mg 33 27 $1.42
J2919 Injection, methylprednisolone sodium succinate, 5 mg 254 206 $1.28
A9270 Non-covered item or service 7,176 1,899 $0.59
96377 42 24 $0.00
76801 50 40 $0.00
96411 23 14 $0.00
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 613 508 $0.00
J1171 Injection, hydromorphone, 0.1 mg 97 78 $0.00
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 382 346 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 392 294 $0.00
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 30 26 $0.00
J0692 Injection, cefepime hydrochloride, 500 mg 56 41 $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 19 14 $0.00
J0737 Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg 23 21 $0.00
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml 34 22 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 19 14 $0.00