Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $31.31M by Medicaid between Jan 2018 and Dec 2024, across 168 billing codes. Its largest line is 99284, emergency room visit (serious) — 35% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
JOHNSON CITY, TN 37604
JOHNSON CITY, TN 37604
33aNPI1972606465assigned 09/07/2006
33bProvider typePsychiatric Hospital Unit
28Total paid$31.31M
24GClaims546,638
24DCodes billed168
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Psychiatric Hospital Unit providers in Tennessee
Rank by total paid#3 of 11
Median peer was paid$159K
This provider vs. median196×
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 | 78,661 | $3.52M | |
| 2019 | 87,797 | $3.41M | |
| 2020 | 52,221 | $2.20M | |
| 2021 | 78,573 | $4.80M | |
| 2022 | 85,206 | $5.88M | |
| 2023 | 93,158 | $6.16M | |
| 2024incomplete | 71,022 | $5.36M |
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 | 35% | 46,296 | 43,190 | $10.99M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 17% | 32,762 | 31,400 | $5.41M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 16% | 22,983 | 19,985 | $4.90M |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | 10% | 13,204 | 12,749 | $3.25M |
| 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 | 2.6% | 16,344 | 15,667 | $804K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 2.5% | 20,710 | 17,230 | $767K |
| G0378 | Hospital observation service, per hour | 2.1% | 3,498 | 3,010 | $669K |
| 96361 | Intravenous infusion, hydration; each additional hour | 1.6% | 2,855 | 1,989 | $487K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.5% | 4,864 | 4,550 | $484K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.2% | 3,121 | 3,044 | $389K |
| 41899 | Unlisted procedure, dentoalveolar structures | 1.2% | 1,098 | 1,073 | $365K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 67,711 | 51,063 | $259K |
156 more codes
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 2,788 | $232K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 9,695 | $164K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 241 | $161K |
| 80053 | Comprehensive metabolic panel | <1% | 34,223 | $133K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 309 | $116K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 1,007 | $115K |
| 87631 | <1% | 1,823 | $114K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 965 | $106K |
| 84484 | <1% | 11,595 | $100K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 52,811 | $96K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 3,292 | $59K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 4,178 | $54K |
| 97597 | <1% | 2,059 | $50K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 577 | $49K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 1,371 | $48K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 15,100 | $48K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 594 | $45K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,124 | $43K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 1,803 | $43K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 1,050 | $43K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 444 | $33K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 4,639 | $32K |
| 80047 | <1% | 14,434 | $32K | |
| 81001 | <1% | 12,302 | $31K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,618 | $30K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 9,739 | $28K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 4,337 | $27K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 1,585 | $25K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 162 | $24K |
| 80076 | <1% | 15,806 | $24K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 1,161 | $23K |
| 84439 | <1% | 2,993 | $22K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 288 | $21K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 1,804 | $18K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 63 | $18K |
| 71045 | Radiologic examination, chest; single view | <1% | 5,545 | $18K |
| 74018 | <1% | 967 | $14K | |
| 95813 | <1% | 119 | $14K | |
| 77336 | <1% | 430 | $14K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 607 | $13K |
| 67311 | <1% | 12 | $13K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,790 | $12K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,516 | $10K |
| 83880 | <1% | 1,444 | $9K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 60 | $9K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 247 | $8K |
| 83735 | <1% | 4,501 | $8K | |
| G0379 | Direct admission of patient for hospital observation care | <1% | 180 | $7K |
| 84703 | <1% | 1,676 | $7K | |
| 77300 | <1% | 113 | $7K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 20 | $7K |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | <1% | 6,285 | $7K |
| 85027 | <1% | 3,807 | $6K | |
| 80061 | Lipid panel | <1% | 1,165 | $6K |
| 83690 | <1% | 2,166 | $6K | |
| 77412 | <1% | 109 | $6K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,392 | $6K |
| 77334 | <1% | 60 | $6K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 5,236 | $5K |
| 82784 | <1% | 943 | $5K | |
| 87077 | <1% | 1,440 | $5K | |
| 87088 | <1% | 1,072 | $5K | |
| 86140 | <1% | 1,451 | $5K | |
| 94375 | <1% | 71 | $4K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,169 | $4K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 6,360 | $4K |
| 86364 | <1% | 363 | $4K | |
| 94761 | <1% | 2,361 | $4K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | <1% | 115 | $4K |
| 86901 | <1% | 400 | $3K | |
| 82728 | <1% | 883 | $3K | |
| 95819 | <1% | 27 | $3K | |
| 74019 | <1% | 437 | $3K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 19 | $3K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 201 | $3K |
| 96376 | <1% | 734 | $3K | |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 255 | $3K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 26 | $2K |
| 82607 | <1% | 747 | $2K | |
| 87625 | <1% | 85 | $2K | |
| 84100 | <1% | 1,930 | $2K | |
| 87081 | <1% | 475 | $2K | |
| 85610 | <1% | 1,851 | $2K | |
| 85652 | <1% | 961 | $2K | |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 62 | $2K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 177 | $2K |
| 83550 | <1% | 618 | $1K | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 65 | $1K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 334 | $1K |
| 83615 | <1% | 1,811 | $1K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 517 | $1K |
| 87486 | <1% | 65 | $1K | |
| 87581 | <1% | 65 | $1K | |
| J3490 | Unclassified drugs | <1% | 1,007 | $1K |
| 83540 | <1% | 662 | $1K | |
| 95816 | <1% | 12 | $1K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 20 | $1K |
| 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 | <1% | 86 | $1K |
| 85730 | <1% | 434 | $961.87 | |
| 87522 | Neg quan hep c or qual rna | <1% | 48 | $902.05 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 715 | $821.65 |
| 83516 | <1% | 83 | $778.84 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | <1% | 75 | $691.20 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 3,663 | $668.36 |
| 81003 | <1% | 447 | $617.16 | |
| J3480 | Injection, potassium chloride, per 2 meq | <1% | 815 | $539.51 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 896 | $512.48 |
| 96523 | <1% | 32 | $446.37 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 2,892 | $397.72 |
| J2704 | Injection, propofol, 10 mg | <1% | 5,141 | $337.89 |
| 0001A | <1% | 19 | $306.31 | |
| 87040 | <1% | 76 | $304.54 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 56 | $236.11 |
| 86850 | <1% | 306 | $225.78 | |
| 36416 | <1% | 372 | $213.06 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 1,931 | $200.39 |
| 87186 | <1% | 88 | $198.30 | |
| 86900 | <1% | 404 | $192.03 | |
| 87070 | <1% | 40 | $177.43 | |
| 85045 | <1% | 90 | $168.93 | |
| J7510 | Prednisolone oral, per 5 mg | <1% | 27 | $150.00 |
| S0020 | Injection, bupivicaine hydrochloride, 30 ml | <1% | 61 | $132.36 |
| 93017 | <1% | 17 | $126.56 | |
| 87210 | <1% | 27 | $122.51 | |
| 81025 | <1% | 54 | $111.79 | |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 611 | $100.93 |
| 83605 | <1% | 13 | $83.08 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 448 | $76.52 |
| 82533 | <1% | 12 | $72.06 | |
| J0689 | Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg | <1% | 136 | $61.91 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 71 | $49.78 |
| Q0162 | Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | <1% | 1,727 | $48.07 |
| 82746 | <1% | 13 | $37.48 | |
| 85651 | <1% | 86 | $28.16 | |
| 86141 | <1% | 20 | $18.66 | |
| C9285 | Lidocaine 70 mg/tetracaine 70 mg, per patch | <1% | 15 | $13.83 |
| J1644 | Injection, heparin sodium, per 1000 units | <1% | 110 | $12.30 |
| 84550 | <1% | 13 | $9.89 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 15 | $3.96 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 126 | $1.31 |
| 88312 | 0% | 169 | $0.00 | |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 0% | 18 | $0.00 |
| 99152 | 0% | 67 | $0.00 | |
| C1887 | Catheter, guiding (may include infusion/perfusion capability) | 0% | 13 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 15 | $0.00 |
| 85014 | 0% | 22 | $0.00 | |
| C1894 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser | 0% | 41 | $0.00 |
| 80329 | 0% | 49 | $0.00 | |
| A9270 | Non-covered item or service | 0% | 16 | $0.00 |
| C1769 | Guide wire | 0% | 98 | $0.00 |
| 80320 | 0% | 30 | $0.00 | |
| 84134 | 0% | 13 | $0.00 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 23 | $0.00 |
| 99153 | Mod sedat endo service >5yrs | 0% | 16 | $0.00 |
| J7050 | Infusion, normal saline solution, 250 cc | 0% | 58 | $0.00 |
| J8540 | Dexamethasone, oral, 0.25 mg | 0% | 15 | $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.