Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

WELLMONT MEDICAL ASSOCIATES INC

Internal Medicine, Pulmonary Disease·KINGSPORT, TN·NPI: 1780986257Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$27.8M

$27,840,284

Total Claims

1.2M

Beneficiaries

912K

1.3 claims/patient

Avg Cost/Claim

$24

Monthly Spending Trend

Yearly Spending

2018
$2.8M
+35%
2019
$3.7M
-23%
2020
$2.9M
+51%
2021
$4.4M
+2%
2022
$4.5M
+1%
2023
$4.5M
+12%
2024
$5.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 30% of total spending.

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$8.2M

194K claims · 29.6%

Your Cost: $42.46/claim|Median: $53.41
0.8× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$7.6M

218K claims · 27.4%

Your Cost: $35.02/claim|Median: $37.81
0.9× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$2.4M

21K claims · 8.8%

Your Cost: $114.77/claim|Median: $91.47
1.3× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$1.1M

34K claims · 3.9%

Your Cost: $31.67/claim|Median: $28.46
1.1× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$1.1M

26K claims · 3.8%

Your Cost: $41.38/claim|Median: $39.70
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$942K

47K claims · 3.4%

Your Cost: $19.91/claim|Median: $23.99
0.8× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$846K

11K claims · 3.0%

Your Cost: $78.28/claim|Median: $65.64
1.2× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$715K

13K claims · 2.6%

Your Cost: $55.14/claim|Median: $57.85
1.0× median
87804Normal range

Influenza virus detection, rapid test

$512K

43K claims · 1.8%

Your Cost: $11.80/claim|Median: $12.59
0.9× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$376K

5,742 claims · 1.3%

Your Cost: $65.42/claim|Median: $84.03
0.8× median
99233Normal range

Subsequent hospital care, per day, high complexity

$300K

13K claims · 1.1%

Your Cost: $23.85/claim|Median: $35.30
0.7× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$262K

26K claims · 0.9%

Your Cost: $10.08/claim|Median: $11.48
0.9× median
99223Normal range

Initial hospital care, per day, high complexity

$219K

4,375 claims · 0.8%

Your Cost: $50.08/claim|Median: $67.32
0.7× median
99215Normal range

Office/outpatient visit, high complexity

$193K

3,680 claims · 0.7%

Your Cost: $52.41/claim|Median: $74.09
0.7× median
99309Normal range

Nursing facility care, subsequent, low complexity

$189K

25K claims · 0.7%

Your Cost: $7.49/claim|Median: $14.00
0.5× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$159K

13K claims · 0.6%

Your Cost: $11.91/claim|Median: $9.56
1.2× median
99222Normal range

Initial hospital care, per day, moderate complexity

$122K

2,708 claims · 0.4%

Your Cost: $44.97/claim|Median: $51.25
0.9× median
99211Normal range

Office/outpatient visit, minimal complexity

$121K

9,966 claims · 0.4%

Your Cost: $12.18/claim|Median: $12.93
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$116K

4,927 claims · 0.4%

Your Cost: $23.62/claim|Median: $25.06
0.9× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$100K

1,187 claims · 0.4%

Your Cost: $84.15/claim|Median: $233.73
0.4× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$95K

2,459 claims · 0.3%

Your Cost: $38.82/claim|Median: $40.11
1.0× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$95K

3,420 claims · 0.3%

Your Cost: $27.66/claim|Median: $43.85
0.6× median
99291Normal range

Critical care, first 30-74 minutes

$84K

1,039 claims · 0.3%

Your Cost: $80.80/claim|Median: $101.24
0.8× median
76830Normal range

Ultrasound, transvaginal

$83K

1,386 claims · 0.3%

Your Cost: $59.63/claim|Median: $57.47
1.0× median
90837Normal range

Psychotherapy, 60 minutes

$79K

864 claims · 0.3%

Your Cost: $91.27/claim|Median: $85.66
1.1× median
3074FNormal range

$72K

88K claims · 0.3%

Your Cost: $0.83/claim|Median: $0.11
7.5× median
3078FTop 25%

$69K

79K claims · 0.2%

Your Cost: $0.88/claim|Median: $0.08
11.0× median
95886Normal range

$69K

2,138 claims · 0.2%

Your Cost: $32.44/claim|Median: $67.70
0.5× median
71046Normal range

Chest X-ray, 2 views

$67K

4,423 claims · 0.2%

Your Cost: $15.04/claim|Median: $8.92
1.7× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$65K

3,735 claims · 0.2%

Your Cost: $17.28/claim|Median: $17.85
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$54K

817 claims · 0.2%

Your Cost: $66.41/claim|Median: $75.18
0.9× median
96413Normal range

Chemotherapy administration, IV infusion, up to 1 hour

$53K

940 claims · 0.2%

Your Cost: $55.94/claim|Median: $75.28
0.7× median
76819Normal range

Fetal biophysical profile with non-stress test

$52K

988 claims · 0.2%

Your Cost: $52.47/claim|Median: $49.45
1.1× median
99231Normal range

Subsequent hospital care, per day, low complexity

$50K

3,525 claims · 0.2%

Your Cost: $14.11/claim|Median: $16.77
0.8× median
99443Normal range

Telephone E/M by physician, 21-30 min

$49K

2,958 claims · 0.2%

Your Cost: $16.62/claim|Median: $32.55
0.5× median
36415Normal range

Collection of venous blood by venipuncture

$48K

45K claims · 0.2%

Your Cost: $1.07/claim|Median: $1.57
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$46K

652 claims · 0.2%

Your Cost: $71.23/claim|Median: $74.82
1.0× median
95811Normal range

Sleep study with CPAP titration, polysomnography

$45K

674 claims · 0.2%

Your Cost: $67.45/claim|Median: $255.03
0.3× median
95806Normal range

$45K

1,377 claims · 0.2%

Your Cost: $32.49/claim|Median: $64.51
0.5× median
85025Normal range

Complete blood count (CBC) with differential, automated

$43K

10K claims · 0.2%

Your Cost: $4.10/claim|Median: $4.71
0.9× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$42K

652 claims · 0.1%

Your Cost: $63.95/claim|Median: $41.92
1.5× median
99395Normal range

Preventive medicine, established patient, age 18-39

$42K

633 claims · 0.1%

Your Cost: $65.73/claim|Median: $72.71
0.9× median
90834Normal range

Psychotherapy, 45 minutes

$41K

707 claims · 0.1%

Your Cost: $58.23/claim|Median: $63.65
0.9× median
94729Normal range

$39K

2,494 claims · 0.1%

Your Cost: $15.53/claim|Median: $12.24
1.3× median
76856Normal range

Ultrasound, pelvic, complete

$35K

548 claims · 0.1%

Your Cost: $64.52/claim|Median: $47.58
1.4× median
90853Normal range

Group psychotherapy

$31K

1,377 claims · 0.1%

Your Cost: $22.54/claim|Median: $25.02
0.9× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$29K

11K claims · 0.1%

Your Cost: $2.59/claim|Median: $5.50
0.5× median
Q0091Normal range

$26K

2,082 claims · 0.1%

Your Cost: $12.45/claim|Median: $11.15
1.1× median
99441Normal range

Telephone E/M by physician, 5-10 min

$23K

1,298 claims · 0.1%

Your Cost: $17.49/claim|Median: $13.30
1.3× median
97597Normal range

$23K

2,720 claims · 0.1%

Your Cost: $8.31/claim|Median: $21.22
0.4× median

Other Top Providers in Tennessee

View all →

Department of Intellectual and Developmental Disabilities, State of Tn

Public Health or Welfare

$2.60B

Department of Intellectual and Developmental Disabilities, State of Tn

Public Health or Welfare

$1.45B

Tennessee Department of Children's Services

Public Health or Welfare

$781.0M

Youth Villages Inc.

Community/Behavioral Health

$615.3M

Mental Health Cooperative INC

Clinic/Center Mental Health (Including Community

$363.8M

← All providersAll providers in Tennessee →How we detect fraud →