Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

Carilion Healthcare Corporation

Carilion Healthcare Corporation was paid $26.07M by Medicaid between Jan 2018 and Dec 2024, across 201 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 38% of everything it billed.

33Billing provider infoCARILION HEALTHCARE CORPORATION
ROANOKE, VA 24011
33aNPI1447206370assigned 05/25/2006
33bProvider typeMulti-Specialty Clinic/Center
28Total paid$26.07M
24GClaims689,650
24DCodes billed201
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Multi-Specialty Clinic/Center providers in Virginia

Rank by total paid#5 of 27
Median peer was paid$349K
This provider vs. median75×

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

$0$200K$400K$600K2018201920202021202220232024
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
YearClaimsPaid
201862,494$1.44M
2019153,844$5.13M
202099,081$3.60M
202189,892$3.31M
202290,185$3.98M
202394,659$4.42M
2024incomplete99,495$4.20M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 38% 156,048 139,641 $10.03M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 38% 191,055 170,704 $9.93M
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 2.9% 10,702 10,157 $744K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 2.2% 7,083 6,908 $582K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1.4% 5,005 4,721 $375K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1.4% 4,452 4,394 $365K
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 1.3% 3,214 3,086 $331K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1.2% 7,859 3,260 $321K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 1,919 1,833 $238K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 5,408 5,095 $213K
90686 <1% 15,507 15,009 $204K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 31,599 24,866 $152K
189 more codes
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 10,662 $138K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 1,409 $127K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 1,175 $103K
99442 <1% 3,418 $100K
36415 Collection of venous blood by venipuncture <1% 62,546 $97K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 10,689 $93K
99223 Prolong inpt eval add15 m <1% 1,092 $87K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 2,479 $84K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 6,048 $82K
87428 <1% 2,452 $80K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 1,023 $78K
99232 Hospital visit by a doctor, follow-up day <1% 3,117 $75K
99441 <1% 3,597 $62K
99308 Subsequent nursing facility care, per day, straightforward <1% 7,777 $61K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 1,448 $56K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 9,467 $55K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,173 $52K
90670 <1% 2,982 $50K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 810 $49K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 529 $44K
99239 Hospital discharge day management, more than 30 minutes <1% 892 $38K
99215 Doctor's office visit, returning patient (complex) <1% 378 $33K
95886 <1% 309 $33K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 287 $31K
99001 <1% 23,395 $31K
73630 <1% 1,312 $30K
90698 <1% 2,043 $30K
83036 Hemoglobin; glycosylated (A1C) <1% 4,928 $29K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 3,018 $28K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) <1% 929 $27K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 3,996 $26K
20610 <1% 703 $25K
80053 Comprehensive metabolic panel <1% 5,361 $25K
99205 Prolong outpt/office vis <1% 151 $23K
99188 <1% 1,047 $22K
93000 <1% 2,413 $22K
80061 Lipid panel <1% 3,339 $22K
95117 <1% 2,222 $19K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 2,210 $18K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 1,476 $17K
59025 Fetal non-stress test <1% 467 $15K
99000 <1% 13,598 $15K
90656 <1% 747 $14K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 1,208 $13K
95819 <1% 49 $13K
95251 <1% 583 $13K
90651 <1% 540 $13K
99443 <1% 251 $12K
71046 Radiologic examination, chest; 2 views <1% 969 $12K
90680 <1% 791 $11K
93458 <1% 84 $11K
92557 <1% 388 $10K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 91 $9K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 88 $9K
92551 <1% 809 $9K
90677 <1% 482 $8K
90633 <1% 574 $8K
97161 <1% 110 $8K
11721 <1% 480 $8K
76813 <1% 79 $8K
92567 <1% 589 $8K
93016 <1% 594 $7K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 268 $7K
73610 <1% 285 $7K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 144 $7K
94726 <1% 903 $7K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 82 $7K
3078F <1% 1,610 $7K
72100 <1% 243 $6K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 86 $6K
96127 <1% 1,133 $6K
94060 <1% 893 $6K
84443 Thyroid stimulating hormone (TSH) <1% 683 $6K
99307 <1% 1,039 $6K
94729 <1% 1,009 $6K
78451 <1% 152 $6K
3074F <1% 1,402 $6K
81003 <1% 2,605 $5K
99406 <1% 829 $5K
L4387 Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf <1% 50 $5K
91320 <1% 63 $5K
93018 <1% 560 $5K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 861 $5K
93880 <1% 253 $5K
90734 <1% 240 $5K
93970 <1% 200 $5K
90710 <1% 280 $4K
72110 <1% 131 $4K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) <1% 41 $4K
31575 <1% 40 $4K
73564 <1% 138 $4K
93971 <1% 293 $4K
81001 <1% 1,425 $4K
90619 <1% 177 $4K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 39 $3K
64721 <1% 14 $3K
76819 Fetal biophysical profile; without non-stress testing <1% 45 $3K
87807 <1% 244 $3K
99238 Hospital discharge day management, 30 minutes or less <1% 106 $3K
90744 <1% 214 $3K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 29 $3K
90715 <1% 131 $2K
90697 <1% 149 $2K
84439 <1% 448 $2K
81025 <1% 327 $2K
90732 <1% 28 $2K
80048 Basic metabolic panel (calcium, ionized) <1% 401 $2K
90696 <1% 121 $2K
99152 <1% 215 $2K
90636 <1% 26 $2K
82962 <1% 748 $2K
90647 <1% 115 $1K
31231 <1% 12 $1K
96160 <1% 657 $1K
0124A <1% 45 $1K
83655 <1% 117 $1K
99459 <1% 87 $1K
85027 <1% 271 $1K
20611 <1% 15 $1K
93227 <1% 55 $1K
3079F <1% 167 $1K
58300 <1% 13 $1K
0502F <1% 158 $1K
90480 <1% 63 $1K
3075F <1% 189 $977.30
97162 <1% 16 $921.85
96161 <1% 437 $911.50
94010 <1% 46 $898.88
90723 <1% 64 $880.22
73110 <1% 28 $863.97
90700 <1% 60 $825.49
82570 <1% 269 $803.01
82044 <1% 271 $770.25
3077F <1% 106 $750.30
90688 <1% 55 $733.54
85018 <1% 308 $718.15
77067 Screening mammography, bilateral, including computer-aided detection <1% 30 $679.06
99496 <1% 17 $612.10
0071A <1% 15 $598.00
3044F <1% 106 $575.00
90620 <1% 15 $571.32
99305 <1% 32 $554.99
0072A <1% 13 $510.00
73130 <1% 12 $420.12
73030 <1% 15 $410.86
73562 <1% 15 $402.98
72040 <1% 12 $402.86
0004A <1% 12 $336.00
36416 <1% 1,469 $313.78
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 62 $312.25
92558 <1% 15 $305.79
99497 <1% 19 $289.19
93296 <1% 24 $288.98
94375 <1% 12 $253.46
G0008 Administration of influenza virus vaccine <1% 548 $234.95
G0127 Trimming of dystrophic nails, any number <1% 41 $234.61
3080F <1% 40 $225.30
74018 <1% 13 $223.83
82607 <1% 15 $220.18
0054A <1% 12 $210.52
90653 <1% 53 $208.37
90472 Immunization administration, each additional vaccine (list separately) <1% 27 $198.84
71045 Radiologic examination, chest; single view <1% 51 $197.06
93272 <1% 12 $196.73
90713 <1% 14 $188.21
87210 <1% 49 $186.43
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 26 $179.70
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 80 $162.39
90685 <1% 13 $157.30
85014 <1% 55 $143.52
99051 <1% 40 $125.33
90460 Immunization administration through 18 years of age via any route, first or only component <1% 75 $110.20
99304 <1% 16 $97.63
99173 <1% 36 $96.23
93922 <1% 17 $93.75
51798 <1% 13 $84.12
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 308 $68.33
82465 <1% 16 $60.48
81002 <1% 28 $55.26
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care <1% 19 $54.62
90694 <1% 13 $21.00
90461 <1% 12 $20.40
91300 <1% 59 $0.42
91307 <1% 36 $0.24
1126F 0% 79 $0.00
1125F 0% 130 $0.00
1159F 0% 3,028 $0.00
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 0% 17 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 0% 13 $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)
Same official

Other billing entities under PRESCOTT, ELEANOR

Full network →
ProviderLocationPaid
Carilion Medical CenterRoanoke, VA$124.86M
Carilion Medical CenterRoanoke, VA$73.43M
Carilion Medical CenterRoanoke, VA$18.08M
Carilion Rockbridge Community HospitalLexington, VA$11.82M
Carilion Emergency Services, INC.Roanoke, VA$11.09M
Carilion Giles Community HospitalPearisburg, VA$10.32M
Carilion Tazewell Community HospitalTazewell, VA$8.03M
Carilion Medical CenterRoanoke, VA$7.31M
Carilion Giles Community HospitalPearisburg, VA$2.40M
Carilion Giles Community HospitalMartinsville, VA$1.99M
Carilion Giles Community HospitalGalax, VA$1.67M
Carilion Giles Community HospitalRocky Mount, VA$1.14M
Carilion Giles Community HospitalWytheville, VA$880K
Carilion Giles Community HospitalFloyd, VA$697K
Carilion Tazewell Community HospitalTazewell, VA$677K
Carilion Giles Community HospitalTazewell, VA$379K
Carilion Giles Community HospitalHillsville, VA$354K
Carilion Rockbridge Community HospitalBuchanan, VA$322K
Carilion Giles Community HospitalPearisburg, VA$254K
Carilion Rockbridge Community HospitalBedford, VA$241K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.