Physician
Blue Ridge Medical Management Corporation
Blue Ridge Medical Management Corporation was paid $7.97M by Medicaid between Jan 2018 and Dec 2024, across 54 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.
33Billing provider infoBLUE RIDGE MEDICAL MANAGEMENT CORPORATION
GREENEVILLE, TN 37743
GREENEVILLE, TN 37743
33aNPI1467987917assigned 04/21/2017
33bProvider typePediatrics Physician
28Total paid$7.97M
24GClaims259,269
24DCodes billed54
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#14 of 333
Median peer was paid$139K
This provider vs. median57×
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 | 9,379 | $236K | |
| 2019 | 10,641 | $304K | |
| 2020 | 9,830 | $260K | |
| 2021 | 61,036 | $2.04M | |
| 2022 | 58,212 | $1.82M | |
| 2023 | 54,045 | $1.56M | |
| 2024incomplete | 56,126 | $1.75M |
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 | 27% | 53,317 | 43,936 | $2.18M |
| 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 | 19% | 24,805 | 20,199 | $1.50M |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 17% | 12,505 | 9,033 | $1.37M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.7% | 8,005 | 6,996 | $536K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.6% | 9,196 | 7,172 | $525K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.3% | 6,247 | 5,505 | $420K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.2% | 16,709 | 14,479 | $332K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.1% | 4,455 | 3,793 | $324K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1.6% | 4,099 | 2,940 | $131K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 10,926 | 9,432 | $110K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.2% | 8,611 | 7,469 | $98K |
| 96127 | <1% | 12,936 | 11,030 | $58K |
42 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 4,507 | $54K |
| 92551 | <1% | 7,406 | $43K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 5,560 | $41K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,407 | $39K |
| 92552 | <1% | 2,203 | $35K | |
| 99460 | <1% | 624 | $27K | |
| 99173 | <1% | 7,570 | $24K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 489 | $21K |
| 83655 | <1% | 1,697 | $19K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 388 | $17K |
| 90651 | <1% | 1,588 | $8K | |
| 36416 | <1% | 5,415 | $8K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 897 | $7K |
| 90677 | <1% | 1,296 | $6K | |
| 90670 | <1% | 3,422 | $6K | |
| 85018 | <1% | 2,513 | $5K | |
| 54150 | <1% | 35 | $4K | |
| 81003 | <1% | 2,281 | $4K | |
| 90461 | <1% | 9,279 | $4K | |
| 90723 | <1% | 3,648 | $3K | |
| 87807 | <1% | 301 | $3K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,176 | $2K |
| 90734 | <1% | 828 | $2K | |
| 90681 | <1% | 1,670 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 102 | $1K |
| 90716 | <1% | 461 | $1K | |
| 90647 | <1% | 3,490 | $752.27 | |
| 90707 | <1% | 422 | $618.30 | |
| 90686 | <1% | 918 | $407.18 | |
| 90633 | <1% | 1,858 | $380.06 | |
| 96380 | <1% | 12 | $269.63 | |
| 90710 | <1% | 269 | $158.44 | |
| 86308 | <1% | 38 | $153.23 | |
| 90696 | <1% | 303 | $80.58 | |
| 90715 | <1% | 127 | $64.02 | |
| 90700 | <1% | 210 | $37.75 | |
| 3074F | <1% | 6,490 | $30.00 | |
| 3078F | <1% | 6,186 | $30.00 | |
| 90671 | <1% | 217 | $20.04 | |
| 90674 | 0% | 69 | $0.00 | |
| 90688 | 0% | 14 | $0.00 | |
| 99000 | 0% | 72 | $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/CEO)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.