Medicaid Provider Spending

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

MOUNTAIN STATES HEALTH ALLIANCE

NPI: 1891801734 · ELIZABETHTON, TN 37643 · General Acute Care Hospital · NPI assigned 08/22/2006

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

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

$7.25M
Total Medicaid Paid
154,388
Total Claims
130,979
Beneficiaries
83
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date08/22/2006

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 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
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 40,768 $1.57M
2019 32,949 $1.23M
2020 20,439 $982K
2021 17,570 $966K
2022 15,908 $1.01M
2023 16,489 $864K
2024 10,265 $632K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 16,656 15,042 $2.94M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 9,775 8,652 $1.97M
99283 Emergency department visit for the evaluation and management, moderate severity 11,831 11,145 $1.43M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 2,292 2,021 $195K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 7,908 7,057 $178K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 18,106 15,346 $60K
99282 Emergency department visit for the evaluation and management, low to moderate severity 608 574 $55K
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 838 794 $54K
84484 6,264 4,186 $46K
74177 Computed tomography, abdomen and pelvis; with contrast material 726 652 $42K
G0378 Hospital observation service, per hour 732 624 $38K
80053 Comprehensive metabolic panel 15,231 13,107 $37K
70450 Computed tomography, head or brain; without contrast material 869 764 $19K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 6,874 5,097 $18K
96375 Therapeutic injection; each additional sequential IV push 2,675 2,312 $15K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 54 44 $14K
83690 3,463 3,104 $13K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 4,067 1,963 $13K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 265 247 $10K
36415 Collection of venous blood by venipuncture 10,264 7,731 $9K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 487 430 $9K
84703 1,471 1,374 $8K
J2405 Injection, ondansetron hydrochloride, per 1 mg 2,340 2,058 $8K
71046 Radiologic examination, chest; 2 views 1,672 1,558 $7K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,410 1,374 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,094 1,000 $6K
96361 Intravenous infusion, hydration; each additional hour 1,048 862 $5K
71045 Radiologic examination, chest; single view 2,642 2,340 $5K
87077 1,661 1,614 $4K
80048 Basic metabolic panel (calcium, ionized) 2,534 1,894 $3K
J1650 Injection, enoxaparin sodium, 10 mg 318 173 $3K
81001 4,648 4,207 $3K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 238 221 $2K
85027 1,090 891 $2K
80061 Lipid panel 232 225 $2K
85730 863 743 $2K
85610 1,371 1,159 $2K
87088 377 347 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 73 63 $2K
74022 213 201 $2K
72125 Computed tomography, cervical spine; without contrast material 27 26 $1K
0202U Oncology (prostate), multianalyte, gene expression profiling 18 18 $1K
81003 2,302 2,067 $1K
83735 576 437 $1K
87040 384 196 $892.76
84443 Thyroid stimulating hormone (TSH) 191 174 $841.49
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 1,962 1,735 $799.65
83880 146 125 $779.75
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 18 17 $718.34
74176 Computed tomography, abdomen and pelvis; without contrast material 30 28 $707.77
96376 116 55 $642.00
87081 126 112 $625.06
G0463 Hospital outpatient clinic visit for assessment and management of a patient 33 29 $613.72
81025 178 168 $474.80
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 181 91 $325.78
73630 31 31 $272.53
87186 54 52 $271.52
73610 33 28 $260.56
72100 68 65 $248.69
12001 14 12 $219.18
73130 31 28 $176.41
J1100 Injection, dexamethasone sodium phosphate, 1 mg 135 119 $156.65
82607 70 52 $125.70
73562 14 13 $114.10
84134 47 40 $106.61
73030 13 12 $97.80
84100 90 68 $79.42
J1885 Injection, ketorolac tromethamine, per 15 mg 971 897 $75.91
83036 Hemoglobin; glycosylated (A1C) 44 43 $68.11
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 16 15 $64.91
87807 13 13 $52.04
J2270 Injection, morphine sulfate, up to 10 mg 188 166 $46.37
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 12 12 $30.71
J7030 Infusion, normal saline solution , 1000 cc 439 397 $22.68
86803 12 12 $18.20
J2360 Injection, orphenadrine citrate, up to 60 mg 15 13 $9.18
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 17 13 $7.50
J2704 Injection, propofol, 10 mg 274 215 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 44 37 $0.00
80320 15 13 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 27 24 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 36 36 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 97 79 $0.00