Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Holston Medical Group PC

Holston Medical Group PC was paid $36.90M by Medicaid between Jan 2018 and Dec 2024, across 236 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 31% of everything it billed.

33Billing provider infoHOLSTON MEDICAL GROUP PC
KINGSPORT, TN 37660
33aNPI1831110667assigned 07/21/2006
33bProvider typePediatrics Physician
28Total paid$36.90M
24GClaims1,169,685
24DCodes billed236
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pediatrics Physician providers in Tennessee

Rank by total paid#1 of 333
Median peer was paid$139K
This provider vs. median265×

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.

Box 24A · Dates of service

Paid by month

$0$500K$1.0M2018201920202021202220232024
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
YearClaimsPaid
2018122,855$3.28M
2019158,082$4.52M
2020115,442$4.07M
2021147,013$5.36M
2022174,100$6.71M
2023225,104$6.73M
2024incomplete227,089$6.23M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 31% 247,670 211,025 $11.59M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 29% 261,446 226,192 $10.72M
90460 Immunization administration through 18 years of age via any route, first or only component 4.8% 49,810 38,464 $1.75M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 4.4% 27,451 21,561 $1.63M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 4.4% 23,508 20,550 $1.63M
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 2.2% 10,469 9,813 $829K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2.0% 10,954 9,784 $748K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1.9% 22,638 7,099 $708K
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1.5% 11,439 10,111 $543K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1.4% 11,729 11,077 $513K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1.2% 12,184 11,585 $435K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1.0% 5,119 4,349 $379K
224 more codes
99204 Doctor's office visit, new patient (more involved) 1.0% 4,817 $376K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 2,480 $364K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 49,839 $325K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 1,841 $244K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 9,557 $230K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) <1% 6,636 $218K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 1,641 $201K
77067 Screening mammography, bilateral, including computer-aided detection <1% 3,607 $185K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 5,586 $146K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 8,619 $128K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 10,727 $113K
97161 <1% 2,111 $107K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 5,729 $102K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 11,928 $102K
99244 Office or other outpatient consultation, moderate to high complexity <1% 848 $100K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 334 $98K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 8,765 $93K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 946 $86K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 1,892 $82K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 495 $78K
20610 <1% 2,729 $77K
96161 <1% 5,550 $73K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 3,082 $71K
99238 Hospital discharge day management, 30 minutes or less <1% 1,573 $71K
99336 <1% 2,668 $64K
96160 <1% 4,530 $63K
95886 <1% 743 $61K
76819 Fetal biophysical profile; without non-stress testing <1% 1,092 $59K
90686 <1% 12,535 $59K
99460 <1% 1,157 $55K
76536 <1% 1,198 $52K
36415 Collection of venous blood by venipuncture <1% 27,635 $50K
96127 <1% 10,187 $45K
99177 <1% 6,092 $43K
95811 <1% 146 $43K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 5,003 $40K
92551 <1% 5,257 $39K
76830 Ultrasound, transvaginal <1% 428 $38K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 5,314 $31K
90670 <1% 10,492 $31K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 180 $30K
95911 <1% 261 $29K
99232 Hospital visit by a doctor, follow-up day <1% 1,892 $28K
92567 <1% 2,739 $26K
99199 Unlisted special service, procedure or report <1% 7,473 $25K
99223 Prolong inpt eval add15 m <1% 521 $24K
72141 <1% 183 $24K
81001 <1% 9,634 $22K
71046 Radiologic examination, chest; 2 views <1% 1,249 $22K
95117 <1% 2,653 $22K
64721 <1% 88 $21K
99442 <1% 673 $19K
43235 <1% 265 $19K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 120 $18K
11721 <1% 3,094 $17K
77063 Screening digital breast tomosynthesis, bilateral <1% 691 $17K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 191 $17K
90723 <1% 9,099 $16K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 292 $16K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 247 $16K
73130 <1% 720 $15K
54150 <1% 94 $15K
99174 <1% 1,459 $14K
90680 <1% 7,251 $14K
99173 <1% 2,610 $14K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 171 $14K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 229 $13K
90677 <1% 2,468 $13K
90647 <1% 8,655 $13K
95251 <1% 1,041 $13K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 255 $12K
99215 Doctor's office visit, returning patient (complex) <1% 312 $12K
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% 1,687 $11K
A9575 Injection, gadoterate meglumine, 0.1 ml <1% 993 $11K
73630 <1% 649 $11K
97162 <1% 261 $11K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg <1% 846 $11K
99349 <1% 283 $11K
99335 <1% 637 $10K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 520 $10K
87807 <1% 880 $10K
90651 <1% 992 $10K
73221 <1% 61 $9K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 2,373 $9K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 52 $9K
71250 <1% 145 $8K
77080 <1% 696 $8K
73110 <1% 327 $8K
94010 <1% 400 $8K
90633 <1% 3,461 $7K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml <1% 709 $7K
99239 Hospital discharge day management, more than 30 minutes <1% 308 $7K
99462 <1% 270 $7K
99490 Ccm add 20min <1% 3,482 $6K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 48 $6K
73565 <1% 494 $6K
76642 <1% 145 $6K
76801 <1% 77 $6K
73560 <1% 486 $6K
81003 <1% 4,007 $6K
86738 <1% 767 $6K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 29 $5K
43249 <1% 40 $5K
81025 <1% 977 $5K
99459 <1% 378 $5K
G0447 Face-to-face behavioral counseling for obesity, 15 minutes <1% 414 $4K
43450 <1% 170 $4K
95909 <1% 53 $4K
94726 <1% 199 $4K
90734 <1% 776 $4K
0012A <1% 141 $4K
92553 <1% 248 $4K
90656 <1% 734 $4K
70450 Computed tomography, head or brain; without contrast material <1% 43 $3K
94729 <1% 160 $3K
91200 <1% 181 $3K
90461 <1% 3,609 $3K
99243 <1% 37 $3K
95800 <1% 29 $3K
76770 <1% 52 $3K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 94 $3K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 531 $3K
90671 <1% 1,593 $3K
99441 <1% 199 $3K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 527 $3K
99439 <1% 866 $2K
0011A <1% 167 $2K
90715 <1% 215 $2K
73030 <1% 109 $2K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 17 $2K
90716 <1% 659 $2K
99443 <1% 90 $2K
93244 <1% 201 $2K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 12 $2K
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit <1% 2,182 $2K
74018 <1% 77 $2K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 15 $1K
36416 <1% 794 $1K
11750 <1% 16 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 130 $1K
99050 <1% 87 $1K
97597 <1% 72 $1K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 14 $1K
99306 Prolong nursin fac eval 15m <1% 137 $1K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 14 $1K
93242 <1% 201 $1K
90707 <1% 654 $1K
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf <1% 38 $986.49
90662 <1% 337 $970.36
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) <1% 54 $926.89
3078F <1% 19,712 $903.92
77066 Tomosynthesis, mammo <1% 18 $895.90
72110 <1% 33 $872.47
92557 <1% 29 $872.26
73140 <1% 36 $824.69
90710 <1% 163 $823.37
3074F <1% 23,029 $803.92
G0008 Administration of influenza virus vaccine <1% 1,402 $774.70
93224 <1% 13 $749.22
96380 <1% 42 $720.65
90688 <1% 531 $693.73
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 15 $673.71
93922 <1% 13 $657.06
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 483 $653.51
0071A <1% 18 $641.00
99406 <1% 330 $629.63
90696 <1% 218 $585.39
0072A <1% 14 $560.00
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit <1% 18 $557.67
90674 <1% 1,386 $502.31
3008F <1% 25,626 $502.01
90685 <1% 537 $482.63
69210 <1% 19 $459.48
99308 Subsequent nursing facility care, per day, straightforward <1% 89 $304.53
3079F <1% 6,439 $300.00
87400 <1% 70 $297.99
94664 <1% 54 $296.29
93000 <1% 24 $288.05
99305 <1% 44 $273.94
73562 <1% 16 $270.05
0500F <1% 22 $260.00
85027 <1% 78 $257.02
94060 <1% 16 $255.29
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 205 $234.25
0502F <1% 13,424 $225.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 645 $222.90
11720 <1% 44 $211.47
11719 <1% 77 $176.11
3075F <1% 2,307 $173.58
51798 <1% 60 $156.27
3077F <1% 1,180 $125.00
99310 Prolong nursin fac eval 15m <1% 14 $102.90
0503F <1% 46 $95.04
90672 <1% 37 $77.20
86580 <1% 41 $52.65
90472 Immunization administration, each additional vaccine (list separately) <1% 28 $52.43
99070 <1% 13 $45.00
3046F <1% 46 $35.00
3080F <1% 383 $25.00
90700 <1% 40 $22.68
3044F <1% 41 $20.00
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care <1% 162 $16.45
0501F <1% 27 $10.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg <1% 117 $7.00
91307 <1% 44 $0.03
G8754 Most recent diastolic blood pressure < 90 mmhg <1% 8,044 $0.02
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 0% 90 $0.00
99024 0% 1,596 $0.00
G9664 Patients who are currently statin therapy users or received an order (prescription) for statin therapy 0% 253 $0.00
91301 0% 280 $0.00
G9717 Documentation stating the patient has had a diagnosis of bipolar disorder 0% 82 $0.00
3014F 0% 47 $0.00
G1007 Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program 0% 85 $0.00
94760 0% 32 $0.00
3351F 0% 53 $0.00
1036F 0% 274 $0.00
3052F 0% 13 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 0% 51 $0.00
G9906 Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) 0% 31 $0.00
G9662 Previously diagnosed or have a diagnosis of clinical ascvd, including ascvd procedure 0% 35 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 0% 7,223 $0.00
3288F 0% 434 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 0% 44 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 0% 36 $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 officialARMSTRONG, SHAWNA (CFO)