Medicaid Provider Spending

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

CARILION MEDICAL CENTER

NPI: 1730123472 · ROANOKE, VA 24014 · Multi-Specialty Clinic/Center · NPI assigned 06/15/2006

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

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

$73.43M
Total Medicaid Paid
1,703,973
Total Claims
1,421,685
Beneficiaries
357
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPRESCOTT, ELEANOR (GOVERNMENT PROGRAM MANAGER)
NPI Enumeration Date06/15/2006

Related Entities

Other providers sharing the same authorized official: PRESCOTT, ELEANOR

ProviderCityStateTotal Paid
CARILION MEDICAL CENTER ROANOKE VA $124.86M
CARILION HEALTHCARE CORPORATION ROANOKE VA $26.07M
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 114,120 $2.89M
2019 277,997 $10.73M
2020 228,099 $10.45M
2021 255,166 $11.48M
2022 284,188 $12.49M
2023 293,793 $13.41M
2024 250,610 $11.99M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 201,457 186,958 $14.93M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 194,582 179,005 $10.30M
99232 Subsequent hospital care, per day, moderate complexity 103,690 39,865 $4.15M
99233 Prolong inpt eval add15 m 73,748 29,549 $3.95M
G9012 Other specified case management service not elsewhere classified 12,899 12,410 $3.15M
99215 Prolong outpt/office vis 22,153 21,199 $2.61M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 19,645 18,786 $2.22M
99223 Prolong inpt eval add15 m 21,030 19,526 $2.06M
J0585 Injection, onabotulinumtoxina, 1 unit 2,548 1,543 $1.61M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 19,041 18,111 $1.37M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 16,307 15,949 $1.35M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 24,068 22,772 $1.32M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 15,101 12,496 $1.22M
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 18,989 17,106 $1.21M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 11,095 4,326 $1.10M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 14,550 13,808 $1.08M
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 5,914 5,618 $848K
99239 Hospital discharge day management, more than 30 minutes 14,592 13,508 $825K
74177 Computed tomography, abdomen and pelvis; with contrast material 11,426 10,853 $735K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 146,782 121,756 $733K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 8,346 8,222 $691K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care 303 291 $664K
99222 Initial hospital care, per day, moderate complexity 7,981 7,391 $615K
99205 Prolong outpt/office vis 3,692 3,589 $568K
90834 Psychotherapy, 45 minutes with patient 8,594 5,619 $557K
H0005 Alcohol and/or drug services; group counseling by a clinician 16,874 8,676 $525K
71045 Radiologic examination, chest; single view 98,405 77,020 $525K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 4,203 3,805 $447K
70450 Computed tomography, head or brain; without contrast material 14,021 12,548 $376K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 4,695 4,471 $360K
77067 Screening mammography, bilateral, including computer-aided detection 11,116 10,886 $326K
90686 23,921 23,467 $324K
95819 2,063 1,914 $322K
76819 Fetal biophysical profile; without non-stress testing 4,146 2,874 $280K
71275 Computed tomographic angiography, chest, with contrast material 4,151 3,953 $266K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,907 2,848 $263K
99188 12,334 12,045 $261K
90792 Psychiatric diagnostic evaluation with medical services 1,580 1,497 $246K
90791 Psychiatric diagnostic evaluation 1,878 1,808 $230K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 6,741 6,104 $202K
76705 Ultrasound, abdominal, real time with image documentation; limited 8,828 8,384 $187K
90670 10,807 10,550 $162K
59025 Fetal non-stress test 4,315 3,179 $161K
64615 1,468 1,380 $159K
96112 1,287 1,200 $158K
90853 Group psychotherapy (other than of a multiple-family group) 7,986 4,386 $155K
94010 5,578 5,411 $150K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 2,751 2,684 $145K
99417 Prolong home eval add 15m 3,431 3,170 $143K
74018 23,670 18,299 $141K
74176 Computed tomography, abdomen and pelvis; without contrast material 2,179 2,094 $132K
76825 605 534 $130K
76830 Ultrasound, transvaginal 4,200 4,083 $130K
92551 12,360 12,146 $129K
99231 Subsequent hospital care, per day, straightforward or low complexity 5,366 2,126 $128K
96110 Developmental screening, with scoring and documentation, per standardized instrument 12,593 8,326 $127K
71046 Radiologic examination, chest; 2 views 16,974 15,868 $125K
95886 1,292 1,180 $122K
95816 844 776 $117K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 857 841 $109K
H0004 Behavioral health counseling and therapy, per 15 minutes 1,550 1,047 $109K
90680 7,751 7,506 $106K
93970 5,478 4,989 $104K
90723 7,454 7,266 $103K
90837 Psychotherapy, 53 minutes with patient 1,026 686 $100K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 2,027 1,915 $99K
90647 7,372 7,184 $92K
20611 1,374 1,181 $88K
93000 7,194 6,924 $86K
72125 Computed tomography, cervical spine; without contrast material 2,345 2,260 $84K
72141 1,589 1,544 $83K
20610 2,084 1,660 $83K
93971 6,338 5,807 $82K
96127 13,956 11,426 $79K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,878 1,832 $78K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 1,741 1,691 $77K
70551 Magnetic resonance imaging, brain; without contrast material 1,607 1,491 $76K
99238 Hospital discharge day management, 30 minutes or less 1,477 1,397 $74K
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) 8,599 8,285 $73K
70498 1,116 1,078 $70K
90633 4,951 4,780 $69K
96130 704 677 $67K
90836 787 738 $67K
78815 Positron emission tomography (PET) for limited area imaging 1,108 1,050 $66K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 346 321 $64K
95810 Polysomnography; sleep staging with 4 or more additional parameters 833 767 $63K
93325 4,763 4,300 $62K
92567 4,728 4,552 $61K
36415 Collection of venous blood by venipuncture 30,335 28,975 $60K
71250 1,614 1,537 $60K
99221 1,279 1,162 $60K
95251 1,992 1,939 $59K
83036 Hemoglobin; glycosylated (A1C) 7,052 6,850 $58K
J1050 Injection, medroxyprogesterone acetate, 1 mg 697 678 $58K
77063 Screening digital breast tomosynthesis, bilateral 2,258 2,229 $57K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,586 1,179 $57K
70496 894 863 $56K
76820 1,480 889 $56K
96040 2,408 2,287 $55K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 644 580 $54K
72110 3,240 3,114 $52K
95951 354 135 $52K
11721 3,955 3,493 $52K
76642 1,931 1,788 $51K
90651 2,541 2,499 $50K
99309 Subsequent nursing facility care, per day, low to moderate complexity 4,958 3,929 $49K
92579 1,228 1,190 $47K
98929 734 711 $46K
90832 Psychotherapy, 30 minutes with patient 821 737 $45K
99442 1,097 1,049 $44K
99284 Emergency department visit for the evaluation and management, high severity 594 548 $44K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 840 814 $43K
90677 2,053 1,960 $43K
92557 1,503 1,455 $41K
96137 598 570 $40K
72132 856 836 $39K
99381 613 560 $39K
76770 1,435 1,377 $39K
96131 443 395 $39K
72170 3,447 3,328 $39K
74183 479 472 $38K
72082 1,239 1,189 $38K
73630 5,052 4,437 $37K
99283 Emergency department visit for the evaluation and management, moderate severity 1,079 890 $36K
73030 4,422 3,981 $35K
95720 258 104 $34K
93880 1,721 1,617 $34K
95806 980 921 $34K
90656 1,810 1,806 $33K
77066 Tomosynthesis, mammo 773 748 $33K
90847 Family psychotherapy with the patient present, 50 minutes 298 284 $30K
74174 394 372 $30K
99220 319 306 $30K
31231 188 180 $30K
81025 4,142 3,954 $29K
76801 392 364 $29K
73562 3,321 2,827 $28K
72129 616 604 $28K
73564 2,753 2,389 $28K
99173 10,878 10,689 $28K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 317 312 $27K
77065 Tomosynthesis, mammo 815 768 $27K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 829 735 $27K
85018 10,525 10,271 $26K
92558 1,298 1,265 $25K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,911 1,789 $24K
94060 1,151 1,085 $24K
73502 2,724 2,524 $24K
72100 2,578 2,446 $24K
96136 650 627 $23K
76536 1,046 1,027 $23K
59510 12 12 $23K
96161 8,959 8,512 $23K
90697 1,361 1,291 $22K
73130 3,007 2,506 $22K
64493 255 229 $21K
93308 676 599 $21K
90734 1,185 1,175 $21K
73610 2,876 2,583 $21K
99443 396 377 $20K
93295 1,023 980 $20K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,356 654 $19K
77077 926 871 $18K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,012 2,919 $18K
99219 180 172 $18K
76813 205 185 $18K
99384 170 162 $17K
99152 2,002 1,800 $17K
93321 1,222 1,092 $16K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 103 100 $15K
72158 182 174 $15K
95811 219 193 $14K
77062 234 230 $14K
93297 1,135 1,068 $14K
88738 3,418 3,316 $14K
72131 391 379 $14K
71271 384 368 $13K
90710 902 884 $13K
96111 130 121 $13K
43775 13 13 $12K
93294 1,010 963 $12K
95913 67 61 $12K
72040 1,330 1,242 $12K
62323 159 155 $11K
99308 Subsequent nursing facility care, per day, straightforward 1,154 774 $11K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 207 184 $11K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 767 752 $11K
72050 960 913 $11K
99441 413 394 $11K
90707 727 716 $11K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 211 206 $10K
90716 692 680 $10K
93458 57 56 $10K
90715 485 476 $10K
70486 295 292 $10K
70491 186 180 $10K
42820 Tonsillectomy and adenoidectomy; younger than age 12 42 40 $9K
72126 193 189 $9K
90696 647 636 $9K
69210 232 221 $9K
99310 Prolong nursin fac eval 15m 742 667 $9K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,817 1,700 $9K
95909 87 82 $9K
90700 609 594 $9K
73110 1,261 1,122 $9K
73590 1,387 1,192 $9K
83655 692 664 $9K
49083 95 53 $9K
64494 185 167 $8K
90620 273 271 $8K
93298 565 536 $8K
73560 1,247 1,090 $8K
90619 400 394 $7K
99307 1,240 494 $7K
77061 163 154 $6K
76506 259 216 $6K
3078F 1,716 1,700 $6K
73090 895 733 $6K
64483 63 63 $6K
0071A 120 120 $5K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 152 151 $5K
3074F 1,306 1,293 $5K
76775 238 230 $5K
93975 133 120 $5K
93227 345 337 $4K
76818 48 37 $4K
80061 Lipid panel 361 352 $4K
51701 143 124 $4K
76870 171 162 $4K
95911 26 24 $4K
43235 43 40 $4K
0072A 92 92 $4K
73552 568 497 $4K
73100 445 397 $4K
94729 657 636 $4K
73080 508 479 $4K
72156 45 41 $4K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 25 24 $4K
73140 594 552 $3K
99000 5,102 3,915 $3K
95910 27 26 $3K
73221 65 64 $3K
G9001 Coordinated care fee, initial rate 132 123 $3K
88720 676 549 $3K
73700 79 71 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 63 59 $3K
95874 73 66 $3K
72128 77 77 $3K
99401 222 195 $3K
96160 1,271 1,212 $3K
95012 176 173 $2K
94726 217 202 $2K
95885 34 30 $2K
93320 54 54 $2K
99217 53 48 $2K
29075 26 22 $2K
36416 6,794 6,540 $2K
81003 999 914 $2K
76882 66 62 $2K
31575 26 24 $2K
70360 220 219 $2K
76700 Ultrasound, abdominal, real time with image documentation; complete 54 52 $2K
29065 17 14 $2K
99292 18 12 $2K
99306 Prolong nursin fac eval 15m 26 25 $2K
73070 224 194 $1K
72146 26 26 $1K
93296 113 111 $1K
99459 146 140 $1K
82962 635 601 $1K
72120 63 63 $1K
74022 119 81 $1K
20550 40 24 $1K
72197 14 14 $1K
72070 164 158 $1K
0002A 30 29 $1K
0001A 29 29 $1K
62321 17 14 $1K
95822 28 25 $1K
90732 14 13 $1K
82465 263 263 $1K
91320 12 12 $1K
20553 27 24 $990.36
73522 86 84 $965.38
90636 12 12 $959.88
11102 12 12 $930.35
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 64 54 $927.59
82950 202 198 $868.79
0502F 172 157 $800.00
90685 60 60 $735.84
90381 53 53 $697.21
90480 27 26 $684.00
77012 12 12 $671.91
77072 84 81 $654.00
99422 29 24 $635.50
81000 210 196 $620.12
76937 32 25 $611.62
0124A 16 16 $573.43
99406 71 65 $565.26
G0463 Hospital outpatient clinic visit for assessment and management of a patient 106 92 $563.04
11056 29 25 $502.72
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 16 16 $500.73
93280 14 14 $492.07
73060 76 64 $485.46
93016 38 36 $479.11
70487 12 12 $468.31
93922 70 68 $468.00
93272 27 27 $463.26
76641 13 12 $452.49
73503 13 13 $445.70
74240 13 13 $416.80
76885 12 12 $390.15
77080 50 50 $381.28
99305 46 31 $375.37
93018 38 36 $330.19
90460 Immunization administration through 18 years of age via any route, first or only component 53 53 $306.52
70250 46 37 $297.26
74300 19 19 $276.07
87210 57 56 $272.68
92504 15 14 $263.97
99051 2,127 2,043 $261.27
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 16 12 $256.65
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 15 13 $254.05
93926 16 14 $252.43
77073 12 12 $225.64
3075F 28 28 $225.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 458 427 $223.80
3044F 73 73 $220.30
78264 12 12 $211.82
77001 13 13 $197.72
85025 Blood count; complete (CBC), automated, and automated differential WBC count 39 39 $195.06
G0127 Trimming of dystrophic nails, any number 59 51 $166.52
98960 14 14 $165.06
72081 14 12 $160.80
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass 13 12 $129.42
73000 18 17 $128.02
80047 14 14 $122.64
73120 15 14 $118.30
Q4012 Cast supplies, short arm cast, pediatric (0-10 years), fiberglass 19 17 $112.01
73620 14 13 $105.20
85027 15 15 $101.60
51798 13 13 $101.06
73600 14 12 $98.53
Q4008 Cast supplies, long arm cast, pediatric (0-10 years), fiberglass 13 12 $90.80
3046F 15 15 $85.00
94760 41 39 $55.26
81005 13 12 $13.91
1126F 290 290 $5.40
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 38 27 $4.34
91307 267 262 $2.13
91300 143 125 $0.95
91305 26 26 $0.17
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 43,593 31,210 $0.04
1159F 2,841 2,807 $0.00
3100F 77 58 $0.00
1125F 78 78 $0.00
G0008 Administration of influenza virus vaccine 14 13 $0.00