Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $7.25M by Medicaid between Jan 2018 and Dec 2024, across 83 billing codes. Its largest line is 99284, emergency room visit (serious) — 41% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
ELIZABETHTON, TN 37643
ELIZABETHTON, TN 37643
33aNPI1891801734assigned 08/22/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$7.25M
24GClaims154,388
24DCodes billed83
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Tennessee
Rank by total paid#34 of 71
Median peer was paid$6.96M
This provider vs. median1.0×
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 | 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 | |
| 2024incomplete | 10,265 | $632K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 41% | 16,656 | 15,042 | $2.94M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 27% | 9,775 | 8,652 | $1.97M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 20% | 11,831 | 11,145 | $1.43M |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 2.7% | 2,292 | 2,021 | $195K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 2.5% | 7,908 | 7,057 | $178K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 18,106 | 15,346 | $60K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 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 | <1% | 838 | 794 | $54K |
| 84484 | <1% | 6,264 | 4,186 | $46K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 726 | 652 | $42K |
| G0378 | Hospital observation service, per hour | <1% | 732 | 624 | $38K |
| 80053 | Comprehensive metabolic panel | <1% | 15,231 | 13,107 | $37K |
71 more codes
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 869 | $19K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 6,874 | $18K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,675 | $15K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 54 | $14K |
| 83690 | <1% | 3,463 | $13K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 4,067 | $13K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 265 | $10K |
| 36415 | Collection of venous blood by venipuncture | <1% | 10,264 | $9K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 487 | $9K |
| 84703 | <1% | 1,471 | $8K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,340 | $8K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,672 | $7K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,410 | $7K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,094 | $6K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 1,048 | $5K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,642 | $5K |
| 87077 | <1% | 1,661 | $4K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 2,534 | $3K |
| J1650 | Injection, enoxaparin sodium, 10 mg | <1% | 318 | $3K |
| 81001 | <1% | 4,648 | $3K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 238 | $2K |
| 85027 | <1% | 1,090 | $2K | |
| 80061 | Lipid panel | <1% | 232 | $2K |
| 85730 | <1% | 863 | $2K | |
| 85610 | <1% | 1,371 | $2K | |
| 87088 | <1% | 377 | $2K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 73 | $2K |
| 74022 | <1% | 213 | $2K | |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 27 | $1K |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | <1% | 18 | $1K |
| 81003 | <1% | 2,302 | $1K | |
| 83735 | <1% | 576 | $1K | |
| 87040 | <1% | 384 | $892.76 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 191 | $841.49 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 1,962 | $799.65 |
| 83880 | <1% | 146 | $779.75 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 18 | $718.34 |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 30 | $707.77 |
| 96376 | <1% | 116 | $642.00 | |
| 87081 | <1% | 126 | $625.06 | |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 33 | $613.72 |
| 81025 | <1% | 178 | $474.80 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 181 | $325.78 |
| 73630 | <1% | 31 | $272.53 | |
| 87186 | <1% | 54 | $271.52 | |
| 73610 | <1% | 33 | $260.56 | |
| 72100 | <1% | 68 | $248.69 | |
| 12001 | <1% | 14 | $219.18 | |
| 73130 | <1% | 31 | $176.41 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 135 | $156.65 |
| 82607 | <1% | 70 | $125.70 | |
| 73562 | <1% | 14 | $114.10 | |
| 84134 | <1% | 47 | $106.61 | |
| 73030 | <1% | 13 | $97.80 | |
| 84100 | <1% | 90 | $79.42 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 971 | $75.91 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 44 | $68.11 |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 16 | $64.91 |
| 87807 | <1% | 13 | $52.04 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 188 | $46.37 |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 12 | $30.71 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 439 | $22.68 |
| 86803 | <1% | 12 | $18.20 | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | <1% | 15 | $9.18 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | <1% | 17 | $7.50 |
| J2704 | Injection, propofol, 10 mg | 0% | 274 | $0.00 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 44 | $0.00 |
| 80320 | 0% | 15 | $0.00 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 0% | 27 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 36 | $0.00 |
| J7120 | Ringers lactate infusion, up to 1000 cc | 0% | 97 | $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.