Clinic
Monument Health Network, INC.
Monument Health Network, INC. was paid $2.02M by Medicaid between Jan 2018 and Dec 2024, across 79 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 26% of everything it billed.
33Billing provider infoMONUMENT HEALTH NETWORK, INC.
SPEARFISH, SD 57783
SPEARFISH, SD 57783
33aNPI1902285828assigned 05/26/2015
33bProvider typeMulti-Specialty Clinic/Center
28Total paid$2.02M
24GClaims85,694
24DCodes billed79
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Multi-Specialty Clinic/Center providers in South Dakota
Rank by total paid#3 of 24
Median peer was paid$251K
This provider vs. median8.1×
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 WORSLEY, THOMAS controls 13+ 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 | 14,531 | $329K | |
| 2019 | 14,882 | $330K | |
| 2020 | 8,304 | $185K | |
| 2021 | 13,064 | $323K | |
| 2022 | 11,809 | $283K | |
| 2023 | 11,156 | $235K | |
| 2024incomplete | 11,948 | $336K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 12,163 | 10,519 | $516K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 14% | 4,412 | 3,792 | $277K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10% | 3,218 | 3,149 | $206K |
| 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 | 8.3% | 2,759 | 2,473 | $167K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.4% | 3,886 | 3,564 | $110K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 4.6% | 4,928 | 4,844 | $94K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.3% | 1,420 | 1,280 | $87K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.2% | 1,311 | 1,273 | $85K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 4.0% | 8,211 | 8,010 | $81K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2.5% | 699 | 655 | $51K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | 1.9% | 29 | 28 | $39K |
| 71046 | Radiologic examination, chest; 2 views | 1.6% | 3,196 | 2,601 | $33K |
67 more codes
| 36415 | Collection of venous blood by venipuncture | 1.2% | 5,775 | $24K |
| 90474 | <1% | 2,052 | $20K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 145 | $19K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,076 | $18K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,054 | $17K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 230 | $15K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 424 | $14K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 379 | $13K |
| W0037 | <1% | 4,403 | $13K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 261 | $13K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 114 | $13K |
| 83655 | <1% | 674 | $10K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 157 | $9K |
| 90715 | <1% | 444 | $9K | |
| 92567 | <1% | 526 | $7K | |
| 99460 | <1% | 86 | $7K | |
| 71045 | Radiologic examination, chest; single view | <1% | 958 | $6K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 89 | $6K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 117 | $5K |
| 90686 | <1% | 2,422 | $4K | |
| 87807 | <1% | 251 | $4K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 44 | $3K |
| 92557 | <1% | 97 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 263 | $2K |
| 95117 | <1% | 191 | $2K | |
| 73630 | <1% | 212 | $2K | |
| 74018 | <1% | 167 | $2K | |
| 0071A | <1% | 47 | $2K | |
| 0072A | <1% | 39 | $2K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 29 | $1K |
| 0002A | <1% | 31 | $1K | |
| 73610 | <1% | 102 | $1K | |
| 81003 | <1% | 402 | $905.24 | |
| 90670 | <1% | 2,559 | $848.95 | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | <1% | 14 | $842.78 |
| 92586 | <1% | 17 | $829.20 | |
| 73562 | <1% | 89 | $823.14 | |
| 92587 | <1% | 43 | $694.20 | |
| 0001A | <1% | 17 | $634.72 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 29 | $602.88 |
| 92588 | <1% | 19 | $546.40 | |
| 0500F | <1% | 54 | $475.90 | |
| 90656 | <1% | 200 | $438.00 | |
| 73030 | <1% | 44 | $433.22 | |
| 69210 | <1% | 15 | $390.61 | |
| 90651 | <1% | 115 | $375.28 | |
| 90677 | <1% | 338 | $268.23 | |
| 73110 | <1% | 15 | $186.03 | |
| 98966 | <1% | 12 | $171.00 | |
| 74019 | <1% | 14 | $154.41 | |
| 90707 | <1% | 1,123 | $154.10 | |
| 90633 | <1% | 1,366 | $153.75 | |
| 90685 | <1% | 184 | $71.16 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 0% | 860 | $0.00 |
| 90648 | 0% | 1,238 | $0.00 | |
| 90700 | 0% | 252 | $0.00 | |
| 90734 | 0% | 106 | $0.00 | |
| 91300 | 0% | 129 | $0.00 | |
| 90680 | 0% | 2,081 | $0.00 | |
| 90723 | 0% | 2,326 | $0.00 | |
| 90716 | 0% | 1,109 | $0.00 | |
| 90647 | 0% | 1,243 | $0.00 | |
| 36416 | 0% | 261 | $0.00 | |
| 90696 | 0% | 135 | $0.00 | |
| 91307 | 0% | 97 | $0.00 | |
| G0009 | Administration of pneumococcal vaccine | 0% | 13 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 84 | $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 officialWORSLEY, THOMAS (PRESIDENT SPEARFISH HOSPITAL)
| Provider | Location | Paid |
|---|---|---|
| Monument Health Network, INC. | Spearfish, SD | $1.82M |
| Monument Health Network, INC. | Belle Fourche, SD | $879K |
| Monument Health Network, INC. | Spearfish, SD | $743K |
| Monument Health Network, INC. | Spearfish, SD | $441K |
| Monument Health Network, INC. | Spearfish, SD | $220K |
| Monument Health Network, INC. | Spearfish, SD | $101K |
| Monument Health Network, INC. | Newcastle, WY | $94K |
| Monument Health Network, INC. | Spearfish, SD | $18K |
| Monument Health Network, INC. | Spearfish, SD | $15K |
| Monument Health Network, INC. | Belle Fourche, SD | $14K |
| Monument Health Network, INC. | Spearfish, SD | $8K |
| Monument Health Network, INC. | Spearfish, SD | $2K |
| Monument Health Network, INC. | Buffalo, SD | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.