Medicaid Provider Spending

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

CARILION HEALTHCARE CORPORATION

NPI: 1447206370 · ROANOKE, VA 24011 · Multi-Specialty Clinic/Center · NPI assigned 05/25/2006

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

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

$26.07M
Total Medicaid Paid
689,650
Total Claims
611,492
Beneficiaries
201
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPRESCOTT, ELEANOR (GOVERNMENT PROGRAM MANAGER)
NPI Enumeration Date05/25/2006

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 MEDICAL CENTER ROANOKE VA $18.08M
CARILION ROCKBRIDGE COMMUNITY HOSPITAL LEXINGTON VA $11.82M
CARILION EMERGENCY SERVICES, INC. ROANOKE VA $11.09M
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 62,494 $1.44M
2019 153,844 $5.13M
2020 99,081 $3.60M
2021 89,892 $3.31M
2022 90,185 $3.98M
2023 94,659 $4.42M
2024 99,495 $4.20M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 156,048 139,641 $10.03M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 191,055 170,704 $9.93M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 10,702 10,157 $744K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 7,083 6,908 $582K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 5,005 4,721 $375K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,452 4,394 $365K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 3,214 3,086 $331K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 7,859 3,260 $321K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,919 1,833 $238K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 5,408 5,095 $213K
90686 15,507 15,009 $204K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 31,599 24,866 $152K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 10,662 5,152 $138K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1,409 1,386 $127K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1,175 1,063 $103K
99442 3,418 3,071 $100K
36415 Collection of venous blood by venipuncture 62,546 57,118 $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) 10,689 9,971 $93K
99223 Prolong inpt eval add15 m 1,092 1,021 $87K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,479 2,338 $84K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 6,048 5,834 $82K
87428 2,452 2,340 $80K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,023 871 $78K
99232 Subsequent hospital care, per day, moderate complexity 3,117 1,371 $75K
99441 3,597 3,260 $62K
99308 Subsequent nursing facility care, per day, straightforward 7,777 5,554 $61K
99233 Prolong inpt eval add15 m 1,448 662 $56K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 9,467 8,656 $55K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,173 1,123 $52K
90670 2,982 2,921 $50K
97530 Therapeutic activities, direct patient contact, each 15 minutes 810 462 $49K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 529 516 $44K
99239 Hospital discharge day management, more than 30 minutes 892 814 $38K
99215 Prolong outpt/office vis 378 360 $33K
95886 309 286 $33K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 287 260 $31K
99001 23,395 22,535 $31K
73630 1,312 1,126 $30K
90698 2,043 1,980 $30K
83036 Hemoglobin; glycosylated (A1C) 4,928 4,547 $29K
96110 Developmental screening, with scoring and documentation, per standardized instrument 3,018 2,746 $28K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 929 919 $27K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,996 3,853 $26K
20610 703 526 $25K
80053 Comprehensive metabolic panel 5,361 4,772 $25K
99205 Prolong outpt/office vis 151 150 $23K
99188 1,047 1,029 $22K
93000 2,413 2,303 $22K
80061 Lipid panel 3,339 2,994 $22K
95117 2,222 932 $19K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,210 2,041 $18K
99309 Subsequent nursing facility care, per day, low to moderate complexity 1,476 1,263 $17K
59025 Fetal non-stress test 467 384 $15K
99000 13,598 12,790 $15K
90656 747 746 $14K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,208 1,059 $13K
95819 49 47 $13K
95251 583 533 $13K
90651 540 534 $13K
99443 251 233 $12K
71046 Radiologic examination, chest; 2 views 969 870 $12K
90680 791 763 $11K
93458 84 78 $11K
92557 388 367 $10K
45380 Colonoscopy, flexible; with biopsy, single or multiple 91 82 $9K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 88 85 $9K
92551 809 786 $9K
90677 482 449 $8K
90633 574 553 $8K
97161 110 106 $8K
11721 480 443 $8K
76813 79 73 $8K
92567 589 567 $8K
93016 594 571 $7K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 268 130 $7K
73610 285 253 $7K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 144 136 $7K
94726 903 866 $7K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 82 40 $7K
3078F 1,610 1,570 $7K
72100 243 232 $6K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 86 75 $6K
96127 1,133 1,074 $6K
94060 893 856 $6K
84443 Thyroid stimulating hormone (TSH) 683 629 $6K
99307 1,039 679 $6K
94729 1,009 960 $6K
78451 152 142 $6K
3074F 1,402 1,368 $6K
81003 2,605 2,465 $5K
99406 829 742 $5K
L4387 Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf 50 50 $5K
91320 63 62 $5K
93018 560 538 $5K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 861 752 $5K
93880 253 252 $5K
90734 240 239 $5K
93970 200 190 $5K
90710 280 278 $4K
72110 131 123 $4K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 41 39 $4K
31575 40 38 $4K
73564 138 103 $4K
93971 293 278 $4K
81001 1,425 1,290 $4K
90619 177 175 $4K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 39 37 $3K
64721 14 12 $3K
76819 Fetal biophysical profile; without non-stress testing 45 26 $3K
87807 244 227 $3K
99238 Hospital discharge day management, 30 minutes or less 106 95 $3K
90744 214 203 $3K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 29 29 $3K
90715 131 131 $2K
90697 149 134 $2K
84439 448 409 $2K
81025 327 301 $2K
90732 28 26 $2K
80048 Basic metabolic panel (calcium, ionized) 401 349 $2K
90696 121 119 $2K
99152 215 199 $2K
90636 26 25 $2K
82962 748 679 $2K
90647 115 114 $1K
31231 12 12 $1K
96160 657 601 $1K
0124A 45 45 $1K
83655 117 113 $1K
99459 87 87 $1K
85027 271 242 $1K
20611 15 15 $1K
93227 55 54 $1K
3079F 167 165 $1K
58300 13 13 $1K
0502F 158 133 $1K
90480 63 62 $1K
3075F 189 185 $977.30
97162 16 16 $921.85
96161 437 408 $911.50
94010 46 43 $898.88
90723 64 63 $880.22
73110 28 27 $863.97
90700 60 58 $825.49
82570 269 250 $803.01
82044 271 251 $770.25
3077F 106 104 $750.30
90688 55 51 $733.54
85018 308 291 $718.15
77067 Screening mammography, bilateral, including computer-aided detection 30 27 $679.06
99496 17 16 $612.10
0071A 15 14 $598.00
3044F 106 101 $575.00
90620 15 15 $571.32
99305 32 25 $554.99
0072A 13 13 $510.00
73130 12 12 $420.12
73030 15 12 $410.86
73562 15 12 $402.98
72040 12 12 $402.86
0004A 12 12 $336.00
36416 1,469 1,393 $313.78
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 62 54 $312.25
92558 15 15 $305.79
99497 19 17 $289.19
93296 24 24 $288.98
94375 12 12 $253.46
G0008 Administration of influenza virus vaccine 548 478 $234.95
G0127 Trimming of dystrophic nails, any number 41 38 $234.61
3080F 40 38 $225.30
74018 13 12 $223.83
82607 15 15 $220.18
0054A 12 12 $210.52
90653 53 44 $208.37
90472 Immunization administration, each additional vaccine (list separately) 27 27 $198.84
71045 Radiologic examination, chest; single view 51 42 $197.06
93272 12 12 $196.73
90713 14 14 $188.21
87210 49 41 $186.43
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 26 25 $179.70
J1885 Injection, ketorolac tromethamine, per 15 mg 80 76 $162.39
90685 13 13 $157.30
85014 55 52 $143.52
99051 40 40 $125.33
90460 Immunization administration through 18 years of age via any route, first or only component 75 75 $110.20
99304 16 12 $97.63
99173 36 36 $96.23
93922 17 16 $93.75
51798 13 12 $84.12
J1100 Injection, dexamethasone sodium phosphate, 1 mg 308 275 $68.33
82465 16 16 $60.48
81002 28 24 $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 19 14 $54.62
90694 13 12 $21.00
90461 12 12 $20.40
91300 59 51 $0.42
91307 36 31 $0.24
1126F 79 79 $0.00
1125F 130 128 $0.00
1159F 3,028 2,959 $0.00
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 17 15 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 13 13 $0.00