Physician
Blue Ridge Medical Management Corporation
Blue Ridge Medical Management Corporation was paid $2.87M by Medicaid between Jan 2018 and Dec 2024, across 58 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoBLUE RIDGE MEDICAL MANAGEMENT CORPORATION
KINGSPORT, TN 37660
KINGSPORT, TN 37660
33aNPI1992105431assigned 09/03/2014
33bProvider typePediatrics Physician
28Total paid$2.87M
24GClaims112,650
24DCodes billed58
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Tennessee
Rank by total paid#42 of 333
Median peer was paid$139K
This provider vs. median21×
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 | 16,237 | $378K | |
| 2019 | 20,114 | $464K | |
| 2020 | 8,650 | $199K | |
| 2021 | 10,138 | $323K | |
| 2022 | 15,544 | $422K | |
| 2023 | 19,149 | $491K | |
| 2024incomplete | 22,818 | $590K |
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 | 34% | 22,976 | 19,120 | $969K |
| 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% | 11,342 | 9,307 | $710K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.1% | 3,462 | 3,051 | $233K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.5% | 11,757 | 7,239 | $187K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.3% | 2,267 | 2,011 | $152K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.6% | 2,255 | 1,919 | $132K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 4.4% | 1,096 | 852 | $128K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.1% | 7,107 | 6,168 | $89K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 2.3% | 2,147 | 1,759 | $65K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.9% | 714 | 599 | $53K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 3,276 | 2,683 | $21K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,564 | 774 | $19K |
46 more codes
| 96127 | <1% | 2,230 | $17K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 998 | $10K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 958 | $9K |
| 99177 | <1% | 1,483 | $9K | |
| 92551 | <1% | 1,402 | $9K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 227 | $6K |
| 99173 | <1% | 1,536 | $6K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,297 | $4K |
| 90670 | <1% | 1,011 | $4K | |
| 90686 | <1% | 2,772 | $4K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 44 | $4K |
| 96161 | <1% | 257 | $3K | |
| 0001A | <1% | 96 | $2K | |
| 90461 | <1% | 6,995 | $2K | |
| 87807 | <1% | 209 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 151 | $2K |
| 3074F | <1% | 7,342 | $2K | |
| 3078F | <1% | 7,083 | $2K | |
| 99174 | <1% | 198 | $1K | |
| 0071A | <1% | 41 | $1K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 94 | $1K |
| 99383 | <1% | 12 | $1K | |
| 36416 | <1% | 696 | $900.91 | |
| 90677 | <1% | 151 | $788.46 | |
| 90734 | <1% | 94 | $613.57 | |
| 83655 | <1% | 53 | $549.27 | |
| 99000 | <1% | 2,301 | $545.18 | |
| 90647 | <1% | 331 | $518.51 | |
| 90723 | <1% | 380 | $512.99 | |
| 90661 | <1% | 183 | $501.74 | |
| 90651 | <1% | 101 | $489.60 | |
| 90680 | <1% | 197 | $466.59 | |
| 90672 | <1% | 97 | $285.42 | |
| 90633 | <1% | 95 | $264.66 | |
| 90707 | <1% | 180 | $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) | <1% | 34 | $208.14 |
| 90473 | <1% | 13 | $150.73 | |
| 90688 | <1% | 52 | $137.29 | |
| 94664 | <1% | 18 | $118.36 | |
| 90656 | <1% | 56 | $99.70 | |
| 90685 | <1% | 27 | $45.10 | |
| 81003 | <1% | 15 | $28.37 | |
| 3044F | <1% | 68 | $25.00 | |
| 90716 | <1% | 50 | $22.01 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 14 | $10.11 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 45 | $1.93 |
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.