Physician
Carilion Emergency Services, INC.
Carilion Emergency Services, INC. was paid $11.09M by Medicaid between Jan 2018 and Dec 2024, across 52 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 56% of everything it billed.
33Billing provider infoCARILION EMERGENCY SERVICES, INC.
ROANOKE, VA 24014
ROANOKE, VA 24014
33aNPI1255602694assigned 01/17/2012
33bProvider typeInternal Medicine Physician
28Total paid$11.09M
24GClaims231,879
24DCodes billed52
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Virginia
Rank by total paid#1 of 478
Median peer was paid$17K
This provider vs. median664×
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 PRESCOTT, ELEANOR 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 | 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 | |
| 2024incomplete | 32,288 | $1.49M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 56% | 103,569 | 95,201 | $6.16M |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 17% | 25,102 | 23,957 | $1.91M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 11% | 15,467 | 14,457 | $1.21M |
| 87428 | 3.3% | 10,826 | 10,504 | $365K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.1% | 18,362 | 17,531 | $238K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.1% | 18,073 | 8,599 | $232K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 2.1% | 7,731 | 7,557 | $231K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.6% | 1,497 | 1,464 | $181K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.1% | 1,136 | 1,095 | $126K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 2,451 | 2,305 | $62K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,487 | 1,430 | $61K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 1,151 | 1,038 | $58K |
40 more codes
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 1,292 | $57K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 370 | $29K |
| 73630 | <1% | 1,041 | $28K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,215 | $27K |
| 73610 | <1% | 885 | $26K | |
| 73130 | <1% | 564 | $16K | |
| 81003 | <1% | 7,454 | $15K | |
| 81025 | <1% | 1,425 | $10K | |
| 93000 | <1% | 830 | $10K | |
| 73110 | <1% | 248 | $8K | |
| 99001 | <1% | 2,523 | $4K | |
| 87807 | <1% | 241 | $3K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 390 | $3K |
| 73030 | <1% | 105 | $3K | |
| 3078F | <1% | 667 | $3K | |
| 99051 | <1% | 765 | $2K | |
| 3074F | <1% | 529 | $2K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,071 | $2K |
| 10060 | <1% | 12 | $1K | |
| 3075F | <1% | 211 | $950.30 | |
| 3079F | <1% | 167 | $925.90 | |
| 3077F | <1% | 174 | $901.15 | |
| 12001 | <1% | 17 | $899.94 | |
| 73564 | <1% | 16 | $646.70 | |
| 3080F | <1% | 79 | $500.25 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 97 | $460.03 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 39 | $444.57 |
| 74018 | <1% | 14 | $368.36 | |
| 3044F | <1% | 79 | $350.00 | |
| 73140 | <1% | 12 | $329.09 | |
| 69209 | <1% | 12 | $190.01 | |
| 86308 | <1% | 25 | $137.30 | |
| 82962 | <1% | 32 | $117.63 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 15 | $74.02 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 25 | $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 | <1% | 203 | $27.51 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 27 | $1.85 |
| 1125F | 0% | 77 | $0.00 | |
| 1126F | 0% | 45 | $0.00 | |
| 1159F | 0% | 1,034 | $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 officialPRESCOTT, ELEANOR (GOVERNMENT PROGRAM MANAGER)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.