Hospital
Mountain States Health Alliance
Mountain States Health Alliance was paid $15.47M by Medicaid between Jan 2018 and Dec 2024, across 147 billing codes. Its largest line is 99284, emergency room visit (serious) — 34% of everything it billed.
33Billing provider infoMOUNTAIN STATES HEALTH ALLIANCE
KINGSPORT, TN 37660
KINGSPORT, TN 37660
33aNPI1992813240assigned 08/28/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$15.47M
24GClaims479,919
24DCodes billed147
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Tennessee
Rank by total paid#18 of 71
Median peer was paid$6.96M
This provider vs. median2.2×
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 | 53,677 | $1.60M | |
| 2019 | 75,155 | $1.60M | |
| 2020 | 60,852 | $1.50M | |
| 2021 | 73,293 | $2.21M | |
| 2022 | 72,205 | $2.60M | |
| 2023 | 81,762 | $3.18M | |
| 2024incomplete | 62,975 | $2.78M |
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 | 34% | 27,120 | 24,738 | $5.33M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 16% | 11,111 | 9,643 | $2.50M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 16% | 18,724 | 17,409 | $2.46M |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | 5.1% | 4,847 | 4,601 | $794K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 3.7% | 15,175 | 11,798 | $577K |
| 96361 | Intravenous infusion, hydration; each additional hour | 3.0% | 4,033 | 3,202 | $467K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 2.8% | 5,344 | 4,884 | $427K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.6% | 66,917 | 53,035 | $242K |
| 36415 | Collection of venous blood by venipuncture | 1.5% | 56,100 | 41,354 | $229K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 1.3% | 1,683 | 1,464 | $197K |
| 80053 | Comprehensive metabolic panel | 1.2% | 53,561 | 43,324 | $193K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 1.2% | 1,511 | 836 | $190K |
135 more codes
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.2% | 1,628 | $182K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 2,275 | $133K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 2,657 | $115K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 10,549 | $112K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 1,128 | $98K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 7,417 | $90K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 12,227 | $81K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 543 | $62K |
| 80061 | Lipid panel | <1% | 9,808 | $60K |
| 81001 | <1% | 17,372 | $51K | |
| 82607 | <1% | 8,660 | $48K | |
| 96367 | <1% | 577 | $47K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 323 | $45K |
| 82746 | <1% | 7,986 | $44K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 365 | $42K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,570 | $39K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 10,274 | $36K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 4,214 | $34K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 6,536 | $27K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 9,535 | $26K |
| 84484 | <1% | 5,271 | $24K | |
| 84439 | <1% | 4,887 | $23K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,476 | $21K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 722 | $21K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 125 | $20K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 7,286 | $16K |
| 81003 | <1% | 7,030 | $16K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 248 | $16K |
| 83690 | <1% | 5,802 | $16K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,960 | $15K |
| 95813 | <1% | 32 | $14K | |
| 87077 | <1% | 1,546 | $14K | |
| 81025 | <1% | 2,899 | $13K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,474 | $13K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 145 | $12K |
| 0001A | <1% | 376 | $11K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 5,986 | $10K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | <1% | 13 | $10K |
| 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% | 331 | $10K |
| 83735 | <1% | 3,961 | $10K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 1,215 | $9K |
| 82140 | <1% | 840 | $9K | |
| 0002A | <1% | 269 | $8K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 2,282 | $7K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,623 | $7K |
| 82105 | <1% | 996 | $7K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 12 | $7K |
| 95886 | <1% | 205 | $7K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 32 | $7K |
| 87522 | Neg quan hep c or qual rna | <1% | 271 | $6K |
| J2469 | Injection, palonosetron hcl, 25 mcg | <1% | 84 | $6K |
| 82150 | <1% | 993 | $6K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 96 | $6K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 17 | $6K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 213 | $5K |
| 83880 | <1% | 664 | $5K | |
| 83516 | <1% | 709 | $5K | |
| 85610 | <1% | 2,661 | $5K | |
| G0378 | Hospital observation service, per hour | <1% | 202 | $5K |
| 82728 | <1% | 1,151 | $5K | |
| 85027 | <1% | 2,128 | $5K | |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 35 | $5K |
| 83540 | <1% | 2,150 | $4K | |
| 59025 | Fetal non-stress test | <1% | 20 | $4K |
| 96415 | <1% | 15 | $3K | |
| J3490 | Unclassified drugs | <1% | 478 | $3K |
| 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% | 352 | $3K |
| 87040 | <1% | 621 | $3K | |
| 87902 | <1% | 28 | $3K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 199 | $3K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 13 | $2K |
| 87088 | <1% | 1,340 | $2K | |
| J1453 | Injection, fosaprepitant, 1 mg | <1% | 17 | $2K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 55 | $2K |
| 83550 | <1% | 720 | $2K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 580 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 17 | $2K |
| 85730 | <1% | 558 | $2K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 25 | $1K |
| 87186 | <1% | 976 | $1K | |
| 83605 | <1% | 559 | $863.67 | |
| 84703 | <1% | 260 | $863.65 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 252 | $704.35 |
| 87486 | <1% | 55 | $701.96 | |
| 87581 | <1% | 55 | $648.67 | |
| 87340 | <1% | 136 | $644.88 | |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | <1% | 1,409 | $610.80 |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 55 | $572.69 |
| 86140 | <1% | 240 | $560.18 | |
| 74018 | <1% | 40 | $537.43 | |
| 83615 | <1% | 699 | $513.49 | |
| 86803 | <1% | 62 | $507.50 | |
| 86850 | <1% | 173 | $474.99 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 3,792 | $417.92 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 1,305 | $376.36 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 3,015 | $359.15 |
| 86901 | <1% | 208 | $336.43 | |
| 96376 | <1% | 252 | $309.97 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 54 | $265.44 |
| 82977 | <1% | 78 | $257.04 | |
| 80164 | <1% | 43 | $230.63 | |
| 85379 | <1% | 66 | $223.09 | |
| 86900 | <1% | 212 | $190.38 | |
| 80143 | <1% | 29 | $152.36 | |
| 86708 | <1% | 30 | $142.20 | |
| 83883 | <1% | 26 | $138.64 | |
| 86592 | <1% | 42 | $136.20 | |
| 84080 | <1% | 12 | $132.02 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 570 | $122.13 |
| 85652 | <1% | 92 | $102.67 | |
| 80179 | <1% | 29 | $76.14 | |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 891 | $52.75 |
| 84100 | <1% | 25 | $51.91 | |
| 87081 | <1% | 13 | $50.84 | |
| 80076 | <1% | 20 | $43.80 | |
| 86709 | <1% | 12 | $43.08 | |
| 88304 | <1% | 29 | $42.89 | |
| 87070 | <1% | 16 | $36.90 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 121 | $35.36 |
| 82570 | <1% | 15 | $29.96 | |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 230 | $28.46 |
| 82043 | <1% | 15 | $22.11 | |
| 80320 | <1% | 15 | $21.42 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 291 | $18.81 |
| 84460 | <1% | 16 | $17.16 | |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | <1% | 52 | $16.20 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 758 | $14.59 |
| J2704 | Injection, propofol, 10 mg | <1% | 1,054 | $11.29 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 167 | $10.36 |
| 85007 | <1% | 23 | $7.52 | |
| 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% | 44 | $6.95 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 0% | 13 | $0.00 |
| 94760 | 0% | 13 | $0.00 | |
| 96417 | 0% | 18 | $0.00 | |
| J1171 | Injection, hydromorphone, 0.1 mg | 0% | 16 | $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.