Physician
Blue Ridge Medical Management Corporation
Blue Ridge Medical Management Corporation was paid $390K by Medicaid between Jan 2018 and Jun 2024, across 27 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 84% of everything it billed.
33Billing provider infoBLUE RIDGE MEDICAL MANAGEMENT CORPORATION
ELIZABETHTON, TN 37643
ELIZABETHTON, TN 37643
33aNPI1457693996assigned 03/22/2013
33bProvider typeInternal Medicine Physician
28Total paid$390K
24GClaims25,920
24DCodes billed27
24AFirst – last monthJan 2018 – Jun 2024
Compared with peers
Next to other Internal Medicine Physician providers in Tennessee
Rank by total paid#67 of 581
Median peer was paid$15K
This provider vs. median26×
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 KILGORE, CARL 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 | 3,547 | $59K | |
| 2019 | 3,617 | $75K | |
| 2020 | 2,379 | $49K | |
| 2021 | 2,820 | $65K | |
| 2022 | 5,944 | $52K | |
| 2023 | 5,232 | $54K | |
| 2024incomplete | 2,381 | $37K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 84% | 11,818 | 9,051 | $326K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 13% | 2,413 | 1,950 | $49K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.1% | 577 | 351 | $4K |
| 36415 | Collection of venous blood by venipuncture | <1% | 3,598 | 2,974 | $3K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 510 | 385 | $1K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 233 | 165 | $1K |
| 90686 | <1% | 165 | 137 | $971.26 | |
| 99441 | <1% | 91 | 82 | $890.56 | |
| 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% | 13 | 12 | $581.56 |
| 90674 | <1% | 90 | 75 | $510.49 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 456 | 304 | $385.71 |
| 99307 | <1% | 18 | 14 | $366.96 |
15 more codes
| 3074F | <1% | 2,522 | $340.00 | |
| 3078F | <1% | 1,920 | $320.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 63 | $277.39 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 16 | $204.66 |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | <1% | 19 | $131.64 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 18 | $114.72 |
| 3079F | <1% | 232 | $70.00 | |
| 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% | 55 | $68.01 |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 99 | $60.73 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 16 | $11.41 |
| 3077F | <1% | 49 | $10.00 | |
| 3080F | <1% | 19 | $10.00 | |
| 3075F | <1% | 123 | $10.00 | |
| 4010F | 0% | 673 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 114 | $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 officialKILGORE, CARL (PRESIDENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.