Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › TN › Johnson City › NPI 1619349578
Physician

Blue Ridge Medical Management Corporation

Blue Ridge Medical Management Corporation was paid $1.19M by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 36% of everything it billed.

33Billing provider infoBLUE RIDGE MEDICAL MANAGEMENT CORPORATION
JOHNSON CITY, TN 37604
33aNPI1619349578assigned 10/30/2015
28Total paid$1.19M
24GClaims27,377
24DCodes billed15
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pediatric Gastroenterology Physician providers in Tennessee

Rank by total paid#2 of 13
Median peer was paid$76K
This provider vs. median16×

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

$0$20K$40K2018201920202021202220232024
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
2018816$68K
20191,334$96K
20201,387$90K
20212,241$143K
20225,575$201K
20237,710$272K
2024incomplete8,314$322K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 36% 4,656 4,125 $425K
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 25% 4,799 4,152 $299K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 11% 974 800 $128K
99205 Prolong outpt/office vis 7.6% 757 698 $90K
97802 4.5% 1,356 1,167 $54K
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 3.9% 496 427 $46K
97803 3.6% 1,409 1,156 $43K
99245 3.2% 337 314 $38K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1.7% 477 444 $21K
99244 Office or other outpatient consultation, moderate to high complexity 1.4% 175 152 $17K
99443 1.3% 282 265 $15K
36415 Collection of venous blood by venipuncture <1% 2,653 2,269 $6K
3 more codes
3074F <1% 4,516 $4K
3078F <1% 4,416 $4K
99442 <1% 74 $3K

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)
Same official

Other billing entities under KILGORE, CARL

Full network →

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