Medicaid Provider Spending

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

MOUNTAIN STATES HEALTH ALLIANCE

NPI: 1972606465 · JOHNSON CITY, TN 37604 · Psychiatric Hospital Unit · NPI assigned 09/07/2006

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

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

$31.31M
Total Medicaid Paid
546,638
Total Claims
447,504
Beneficiaries
168
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date09/07/2006

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
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
MOUNTAIN STATES HEALTH ALLIANCE ELIZABETHTON TN $7.25M
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 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
2024 71,022 $5.36M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 46,296 43,190 $10.99M
99283 Emergency department visit for the evaluation and management, moderate severity 32,762 31,400 $5.41M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 22,983 19,985 $4.90M
0202U Oncology (prostate), multianalyte, gene expression profiling 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 16,344 15,667 $804K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 20,710 17,230 $767K
G0378 Hospital observation service, per hour 3,498 3,010 $669K
96361 Intravenous infusion, hydration; each additional hour 2,855 1,989 $487K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 4,864 4,550 $484K
99282 Emergency department visit for the evaluation and management, low to moderate severity 3,121 3,044 $389K
41899 Unlisted procedure, dentoalveolar structures 1,098 1,073 $365K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 67,711 51,063 $259K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 2,788 1,478 $232K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 9,695 8,423 $164K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 241 230 $161K
80053 Comprehensive metabolic panel 34,223 28,508 $133K
95810 Polysomnography; sleep staging with 4 or more additional parameters 309 291 $116K
70450 Computed tomography, head or brain; without contrast material 1,007 867 $115K
87631 1,823 1,771 $114K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 965 860 $106K
84484 11,595 7,216 $100K
36415 Collection of venous blood by venipuncture 52,811 38,285 $96K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 3,292 3,094 $59K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 4,178 3,492 $54K
97597 2,059 1,133 $50K
74177 Computed tomography, abdomen and pelvis; with contrast material 577 519 $49K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 1,371 1,333 $48K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 15,100 10,279 $48K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 594 524 $45K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,124 970 $43K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1,803 1,683 $43K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,050 897 $43K
76705 Ultrasound, abdominal, real time with image documentation; limited 444 379 $33K
71046 Radiologic examination, chest; 2 views 4,639 4,372 $32K
80047 14,434 9,552 $32K
81001 12,302 11,007 $31K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,618 1,578 $30K
80048 Basic metabolic panel (calcium, ionized) 9,739 7,409 $28K
84443 Thyroid stimulating hormone (TSH) 4,337 3,937 $27K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,585 1,449 $25K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 162 154 $24K
80076 15,806 11,079 $24K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,161 1,045 $23K
84439 2,993 2,739 $22K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 288 231 $21K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1,804 1,683 $18K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 63 55 $18K
71045 Radiologic examination, chest; single view 5,545 4,682 $18K
74018 967 899 $14K
95813 119 113 $14K
77336 430 176 $14K
J7030 Infusion, normal saline solution , 1000 cc 607 451 $13K
67311 12 12 $13K
96375 Therapeutic injection; each additional sequential IV push 2,790 2,021 $12K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,516 1,478 $10K
83880 1,444 1,180 $9K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 60 57 $9K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 247 201 $8K
83735 4,501 3,465 $8K
G0379 Direct admission of patient for hospital observation care 180 164 $7K
84703 1,676 1,520 $7K
77300 113 81 $7K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 20 12 $7K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 6,285 3,338 $7K
85027 3,807 3,108 $6K
80061 Lipid panel 1,165 1,083 $6K
83690 2,166 1,917 $6K
77412 109 12 $6K
87086 Culture, bacterial; quantitative colony count, urine 1,392 1,292 $6K
77334 60 36 $6K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 5,236 4,806 $5K
82784 943 847 $5K
87077 1,440 1,375 $5K
87088 1,072 978 $5K
86140 1,451 1,308 $5K
94375 71 70 $4K
83036 Hemoglobin; glycosylated (A1C) 1,169 1,059 $4K
J2405 Injection, ondansetron hydrochloride, per 1 mg 6,360 5,015 $4K
86364 363 335 $4K
94761 2,361 1,119 $4K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 115 48 $4K
86901 400 347 $3K
82728 883 764 $3K
95819 27 25 $3K
74019 437 432 $3K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 19 12 $3K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 201 184 $3K
96376 734 431 $3K
A9585 Injection, gadobutrol, 0.1 ml 255 224 $3K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 26 25 $2K
82607 747 599 $2K
87625 85 78 $2K
84100 1,930 1,412 $2K
87081 475 450 $2K
85610 1,851 1,532 $2K
85652 961 897 $2K
72125 Computed tomography, cervical spine; without contrast material 62 50 $2K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 177 162 $2K
83550 618 530 $1K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 65 62 $1K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 334 157 $1K
83615 1,811 1,467 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 517 304 $1K
87486 65 62 $1K
87581 65 62 $1K
J3490 Unclassified drugs 1,007 477 $1K
83540 662 571 $1K
95816 12 12 $1K
99281 Emergency department visit for the evaluation and management, self-limited or minor 20 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 86 73 $1K
85730 434 381 $961.87
87522 Neg quan hep c or qual rna 48 42 $902.05
J7120 Ringers lactate infusion, up to 1000 cc 715 578 $821.65
83516 83 63 $778.84
J1650 Injection, enoxaparin sodium, 10 mg 75 31 $691.20
J1885 Injection, ketorolac tromethamine, per 15 mg 3,663 3,012 $668.36
81003 447 410 $617.16
J3480 Injection, potassium chloride, per 2 meq 815 496 $539.51
J0690 Injection, cefazolin sodium, 500 mg 896 622 $512.48
96523 32 24 $446.37
J3010 Injection, fentanyl citrate, 0.1 mg 2,892 2,329 $397.72
J2704 Injection, propofol, 10 mg 5,141 4,094 $337.89
0001A 19 19 $306.31
87040 76 50 $304.54
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 56 14 $236.11
86850 306 266 $225.78
36416 372 221 $213.06
J2250 Injection, midazolam hydrochloride, per 1 mg 1,931 1,594 $200.39
87186 88 80 $198.30
86900 404 351 $192.03
87070 40 38 $177.43
85045 90 74 $168.93
J7510 Prednisolone oral, per 5 mg 27 26 $150.00
S0020 Injection, bupivicaine hydrochloride, 30 ml 61 53 $132.36
93017 17 14 $126.56
87210 27 25 $122.51
81025 54 49 $111.79
J1170 Injection, hydromorphone, up to 4 mg 611 397 $100.93
83605 13 13 $83.08
88305 Level IV - Surgical pathology, gross and microscopic examination 448 414 $76.52
82533 12 12 $72.06
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 136 110 $61.91
J2270 Injection, morphine sulfate, up to 10 mg 71 42 $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 1,727 1,627 $48.07
82746 13 12 $37.48
85651 86 79 $28.16
86141 20 14 $18.66
C9285 Lidocaine 70 mg/tetracaine 70 mg, per patch 15 14 $13.83
J1644 Injection, heparin sodium, per 1000 units 110 64 $12.30
84550 13 12 $9.89
J0696 Injection, ceftriaxone sodium, per 250 mg 15 12 $3.96
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 126 65 $1.31
88312 169 162 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 18 12 $0.00
99152 67 52 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 13 12 $0.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 15 12 $0.00
85014 22 13 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 41 26 $0.00
80329 49 25 $0.00
A9270 Non-covered item or service 16 12 $0.00
C1769 Guide wire 98 77 $0.00
80320 30 29 $0.00
84134 13 12 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 23 13 $0.00
99153 Mod sedat endo service >5yrs 16 13 $0.00
J7050 Infusion, normal saline solution, 250 cc 58 27 $0.00
J8540 Dexamethasone, oral, 0.25 mg 15 13 $0.00