Medicaid Provider Spending

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

MOUNTAIN STATES HEALTH ALLIANCE

NPI: 1992813240 · KINGSPORT, TN 37660 · General Acute Care Hospital · NPI assigned 08/28/2006

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

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

$15.47M
Total Medicaid Paid
479,919
Total Claims
396,378
Beneficiaries
147
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date08/28/2006

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
MOUNTAIN STATES HEALTH ALLIANCE JOHNSON CITY TN $31.31M
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
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 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
2024 62,975 $2.78M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 27,120 24,738 $5.33M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 11,111 9,643 $2.50M
99283 Emergency department visit for the evaluation and management, moderate severity 18,724 17,409 $2.46M
0202U Oncology (prostate), multianalyte, gene expression profiling 4,847 4,601 $794K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 15,175 11,798 $577K
96361 Intravenous infusion, hydration; each additional hour 4,033 3,202 $467K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 5,344 4,884 $427K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 66,917 53,035 $242K
36415 Collection of venous blood by venipuncture 56,100 41,354 $229K
74177 Computed tomography, abdomen and pelvis; with contrast material 1,683 1,464 $197K
80053 Comprehensive metabolic panel 53,561 43,324 $193K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1,511 836 $190K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1,628 1,478 $182K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 2,275 1,195 $133K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2,657 2,328 $115K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 10,549 9,093 $112K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,128 1,053 $98K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 7,417 6,912 $90K
84443 Thyroid stimulating hormone (TSH) 12,227 11,023 $81K
70450 Computed tomography, head or brain; without contrast material 543 472 $62K
80061 Lipid panel 9,808 9,103 $60K
81001 17,372 15,287 $51K
82607 8,660 8,041 $48K
96367 577 293 $47K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 323 315 $45K
82746 7,986 7,428 $44K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 365 258 $42K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,570 1,499 $39K
83036 Hemoglobin; glycosylated (A1C) 10,274 9,511 $36K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 4,214 3,652 $34K
96375 Therapeutic injection; each additional sequential IV push 6,536 4,825 $27K
80048 Basic metabolic panel (calcium, ionized) 9,535 6,034 $26K
84484 5,271 3,685 $24K
84439 4,887 4,490 $23K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 3,476 2,715 $21K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 722 620 $21K
74176 Computed tomography, abdomen and pelvis; without contrast material 125 109 $20K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 7,286 5,719 $16K
81003 7,030 6,275 $16K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 248 142 $16K
83690 5,802 5,075 $16K
71046 Radiologic examination, chest; 2 views 1,960 1,747 $15K
95813 32 30 $14K
87077 1,546 1,364 $14K
81025 2,899 2,637 $13K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,474 1,155 $13K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 145 125 $12K
0001A 376 321 $11K
J2405 Injection, ondansetron hydrochloride, per 1 mg 5,986 4,756 $10K
J0585 Injection, onabotulinumtoxina, 1 unit 13 12 $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 331 320 $10K
83735 3,961 3,167 $10K
J7030 Infusion, normal saline solution , 1000 cc 1,215 1,009 $9K
82140 840 784 $9K
0002A 269 215 $8K
87086 Culture, bacterial; quantitative colony count, urine 2,282 2,051 $7K
71045 Radiologic examination, chest; single view 2,623 2,200 $7K
82105 996 961 $7K
95810 Polysomnography; sleep staging with 4 or more additional parameters 12 12 $7K
95886 205 165 $7K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 32 24 $7K
87522 Neg quan hep c or qual rna 271 258 $6K
J2469 Injection, palonosetron hcl, 25 mcg 84 50 $6K
82150 993 954 $6K
97530 Therapeutic activities, direct patient contact, each 15 minutes 96 38 $6K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 17 12 $6K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 213 119 $5K
83880 664 570 $5K
83516 709 576 $5K
85610 2,661 2,110 $5K
G0378 Hospital observation service, per hour 202 150 $5K
82728 1,151 1,062 $5K
85027 2,128 1,674 $5K
71275 Computed tomographic angiography, chest, with contrast material 35 28 $5K
83540 2,150 2,002 $4K
59025 Fetal non-stress test 20 12 $4K
96415 15 12 $3K
J3490 Unclassified drugs 478 292 $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 352 307 $3K
87040 621 316 $3K
87902 28 27 $3K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 199 166 $3K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 13 12 $2K
87088 1,340 1,119 $2K
J1453 Injection, fosaprepitant, 1 mg 17 12 $2K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 55 51 $2K
83550 720 670 $2K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 580 543 $2K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 17 15 $2K
85730 558 504 $2K
76700 Ultrasound, abdominal, real time with image documentation; complete 25 24 $1K
87186 976 826 $1K
83605 559 427 $863.67
84703 260 231 $863.65
J7120 Ringers lactate infusion, up to 1000 cc 252 212 $704.35
87486 55 51 $701.96
87581 55 51 $648.67
87340 136 120 $644.88
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 1,409 778 $610.80
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 55 51 $572.69
86140 240 205 $560.18
74018 40 36 $537.43
83615 699 575 $513.49
86803 62 51 $507.50
86850 173 139 $474.99
J1885 Injection, ketorolac tromethamine, per 15 mg 3,792 3,203 $417.92
J3010 Injection, fentanyl citrate, 0.1 mg 1,305 1,124 $376.36
J1100 Injection, dexamethasone sodium phosphate, 1 mg 3,015 2,233 $359.15
86901 208 157 $336.43
96376 252 163 $309.97
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 54 37 $265.44
82977 78 71 $257.04
80164 43 38 $230.63
85379 66 55 $223.09
86900 212 157 $190.38
80143 29 25 $152.36
86708 30 26 $142.20
83883 26 24 $138.64
86592 42 38 $136.20
84080 12 12 $132.02
J0696 Injection, ceftriaxone sodium, per 250 mg 570 444 $122.13
85652 92 74 $102.67
80179 29 25 $76.14
J1170 Injection, hydromorphone, up to 4 mg 891 614 $52.75
84100 25 15 $51.91
87081 13 13 $50.84
80076 20 16 $43.80
86709 12 12 $43.08
88304 29 27 $42.89
87070 16 13 $36.90
J2270 Injection, morphine sulfate, up to 10 mg 121 83 $35.36
82570 15 13 $29.96
J7050 Infusion, normal saline solution, 250 cc 230 125 $28.46
82043 15 13 $22.11
80320 15 13 $21.42
J0690 Injection, cefazolin sodium, 500 mg 291 249 $18.81
84460 16 14 $17.16
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 52 40 $16.20
J2250 Injection, midazolam hydrochloride, per 1 mg 758 671 $14.59
J2704 Injection, propofol, 10 mg 1,054 910 $11.29
J1200 Injection, diphenhydramine hcl, up to 50 mg 167 119 $10.36
85007 23 14 $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 44 38 $6.95
J2765 Injection, metoclopramide hcl, up to 10 mg 13 12 $0.00
94760 13 12 $0.00
96417 18 12 $0.00
J1171 Injection, hydromorphone, 0.1 mg 16 13 $0.00