Medicaid Provider Spending

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

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

NPI: 1992105431 · KINGSPORT, TN 37660 · Pediatrics Physician · NPI assigned 09/03/2014

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

Authorized official KILGORE, CARL controls 20+ related entities in our dataset. Read more

$2.87M
Total Medicaid Paid
112,650
Total Claims
88,985
Beneficiaries
58
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKILGORE, CARL (PRESIDENT)
NPI Enumeration Date09/03/2014

Related Entities

Other providers sharing the same authorized official: KILGORE, CARL

ProviderCityStateTotal Paid
BLUE RIDGE MEDICAL MANAGGEMENT CORPORATION KINGSPORT TN $2.17M
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JOHNSON CITY TN $1.51M
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION KINGSPORT TN $812K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JOHNSON CITY TN $736K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION ABINGDON VA $713K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION LEBANON VA $549K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION ABINGDON VA $544K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NORTON VA $408K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION ELIZABETHTON TN $390K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION KINGSPORT TN $346K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JONESBOROUGH TN $345K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JOHNSON CITY TN $250K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION RURAL RETREAT VA $232K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION ELIZABETHTON TN $226K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION ABINGDON VA $217K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION KINGSPORT TN $201K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JOHNSON CITY TN $199K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JOHNSON CITY TN $199K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION ABINGDON VA $193K
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION JOHNSON CITY TN $188K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 16,237 $378K
2019 20,114 $464K
2020 8,650 $199K
2021 10,138 $323K
2022 15,544 $422K
2023 19,149 $491K
2024 22,818 $590K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 22,976 19,120 $969K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 11,342 9,307 $710K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,462 3,051 $233K
90460 Immunization administration through 18 years of age via any route, first or only component 11,757 7,239 $187K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,267 2,011 $152K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 2,255 1,919 $132K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,096 852 $128K
96110 Developmental screening, with scoring and documentation, per standardized instrument 7,107 6,168 $89K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 2,147 1,759 $65K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 714 599 $53K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 3,276 2,683 $21K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,564 774 $19K
96127 2,230 1,848 $17K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 998 869 $10K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 958 846 $9K
99177 1,483 1,281 $9K
92551 1,402 1,216 $9K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 227 199 $6K
99173 1,536 1,328 $6K
36415 Collection of venous blood by venipuncture 2,297 1,960 $4K
90670 1,011 883 $4K
90686 2,772 2,501 $4K
99215 Prolong outpt/office vis 44 39 $4K
96161 257 217 $3K
0001A 96 67 $2K
90461 6,995 3,202 $2K
87807 209 194 $2K
90472 Immunization administration, each additional vaccine (list separately) 151 112 $2K
3074F 7,342 6,128 $2K
3078F 7,083 5,920 $2K
99174 198 156 $1K
0071A 41 39 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 94 81 $1K
99383 12 12 $1K
36416 696 570 $900.91
90677 151 111 $788.46
90734 94 79 $613.57
83655 53 42 $549.27
99000 2,301 1,943 $545.18
90647 331 284 $518.51
90723 380 314 $512.99
90661 183 147 $501.74
90651 101 76 $489.60
90680 197 167 $466.59
90672 97 92 $285.42
90633 95 83 $264.66
90707 180 147 $256.77
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) 34 33 $208.14
90473 13 12 $150.73
90688 52 44 $137.29
94664 18 15 $118.36
90656 56 54 $99.70
90685 27 24 $45.10
81003 15 14 $28.37
3044F 68 62 $25.00
90716 50 40 $22.01
J1100 Injection, dexamethasone sodium phosphate, 1 mg 14 12 $10.11
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 45 40 $1.93