Medicaid Provider Spending

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

CARILION EMERGENCY SERVICES, INC.

NPI: 1255602694 · ROANOKE, VA 24014 · Internal Medicine Physician · NPI assigned 01/17/2012

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

Authorized official PRESCOTT, ELEANOR controls 20+ related entities in our dataset. Read more

$11.09M
Total Medicaid Paid
231,879
Total Claims
208,885
Beneficiaries
52
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPRESCOTT, ELEANOR (GOVERNMENT PROGRAM MANAGER)
NPI Enumeration Date01/17/2012

Related Entities

Other providers sharing the same authorized official: PRESCOTT, ELEANOR

ProviderCityStateTotal Paid
CARILION MEDICAL CENTER ROANOKE VA $124.86M
CARILION MEDICAL CENTER ROANOKE VA $73.43M
CARILION HEALTHCARE CORPORATION ROANOKE VA $26.07M
CARILION MEDICAL CENTER ROANOKE VA $18.08M
CARILION ROCKBRIDGE COMMUNITY HOSPITAL LEXINGTON VA $11.82M
CARILION GILES COMMUNITY HOSPITAL PEARISBURG VA $10.32M
CARILION TAZEWELL COMMUNITY HOSPITAL TAZEWELL VA $8.03M
CARILION MEDICAL CENTER ROANOKE VA $7.31M
CARILION GILES COMMUNITY HOSPITAL PEARISBURG VA $2.40M
CARILION GILES COMMUNITY HOSPITAL MARTINSVILLE VA $1.99M
CARILION GILES COMMUNITY HOSPITAL GALAX VA $1.67M
CARILION GILES COMMUNITY HOSPITAL ROCKY MOUNT VA $1.14M
CARILION GILES COMMUNITY HOSPITAL WYTHEVILLE VA $880K
CARILION GILES COMMUNITY HOSPITAL FLOYD VA $697K
CARILION TAZEWELL COMMUNITY HOSPITAL TAZEWELL VA $677K
CARILION GILES COMMUNITY HOSPITAL TAZEWELL VA $379K
CARILION GILES COMMUNITY HOSPITAL HILLSVILLE VA $354K
CARILION ROCKBRIDGE COMMUNITY HOSPITAL BUCHANAN VA $322K
CARILION GILES COMMUNITY HOSPITAL PEARISBURG VA $254K
CARILION ROCKBRIDGE COMMUNITY HOSPITAL BEDFORD VA $241K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 7,280 $322K
2019 29,156 $1.27M
2020 30,371 $1.34M
2021 34,043 $1.63M
2022 49,732 $2.54M
2023 49,009 $2.50M
2024 32,288 $1.49M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 103,569 95,201 $6.16M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 25,102 23,957 $1.91M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 15,467 14,457 $1.21M
87428 10,826 10,504 $365K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 18,362 17,531 $238K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 18,073 8,599 $232K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 7,731 7,557 $231K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,497 1,464 $181K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,136 1,095 $126K
71046 Radiologic examination, chest; 2 views 2,451 2,305 $62K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,487 1,430 $61K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 1,151 1,038 $58K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,292 1,260 $57K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 370 358 $29K
73630 1,041 992 $28K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,215 2,060 $27K
73610 885 842 $26K
73130 564 538 $16K
81003 7,454 7,013 $15K
81025 1,425 1,344 $10K
93000 830 794 $10K
73110 248 236 $8K
99001 2,523 2,444 $4K
87807 241 224 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 390 362 $3K
73030 105 102 $3K
3078F 667 641 $3K
99051 765 695 $2K
3074F 529 512 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 1,071 1,004 $2K
10060 12 12 $1K
3075F 211 205 $950.30
3079F 167 164 $925.90
3077F 174 170 $901.15
12001 17 12 $899.94
73564 16 14 $646.70
3080F 79 77 $500.25
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 97 89 $460.03
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 39 37 $444.57
74018 14 14 $368.36
3044F 79 77 $350.00
73140 12 12 $329.09
69209 12 12 $190.01
86308 25 25 $137.30
82962 32 29 $117.63
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 15 13 $74.02
J0696 Injection, ceftriaxone sodium, per 250 mg 25 24 $33.56
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 203 185 $27.51
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 27 27 $1.85
1125F 77 77 $0.00
1126F 45 45 $0.00
1159F 1,034 1,006 $0.00