Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

CARILION MEDICAL CENTER

Clinic/Center, Multi-Specialty·ROANOKE, VA·NPI: 1730123472Share

Compared to Clinic/Center, Multi-Specialty Peers

Total spending distribution among 12 providers in this specialty

P25MedianP75P90

This provider's total spending of $73.4M is at the 25th percentile among 12 Clinic/Center, Multi-Specialty providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$73.4M

$73,433,320

Total Claims

1.7M

Beneficiaries

1.4M

1.2 claims/patient

Avg Cost/Claim

$43

Monthly Spending Trend

Yearly Spending

2018
$2.9M
+271%
2019
$10.7M
-3%
2020
$10.4M
+10%
2021
$11.5M
+9%
2022
$12.5M
+7%
2023
$13.4M
-11%
2024
$12.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 20% of total spending.

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$14.9M

201K claims · 20.3%

Your Cost: $74.12/claim|Median: $53.41
1.4× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$10.3M

195K claims · 14.0%

Your Cost: $52.91/claim|Median: $37.81
1.4× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$4.2M

104K claims · 5.7%

Your Cost: $40.05/claim|Median: $23.99
1.7× median
99233Normal range

Subsequent hospital care, per day, high complexity

$3.9M

74K claims · 5.4%

Your Cost: $53.55/claim|Median: $35.30
1.5× median
G9012Normal range

Other specified case management service, per 15 minutes

$3.1M

13K claims · 4.3%

Your Cost: $244.02/claim|Median: $137.85
1.8× median
99215Top 25%

Office/outpatient visit, high complexity

$2.6M

22K claims · 3.6%

Your Cost: $117.82/claim|Median: $74.09
1.6× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$2.2M

20K claims · 3.0%

Your Cost: $112.95/claim|Median: $84.03
1.3× median
99223Normal range

Initial hospital care, per day, high complexity

$2.1M

21K claims · 2.8%

Your Cost: $97.81/claim|Median: $67.32
1.5× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$1.6M

2,548 claims · 2.2%

Your Cost: $630.57/claim|Median: $470.36
1.3× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$1.4M

19K claims · 1.9%

Your Cost: $72.05/claim|Median: $57.85
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.3M

16K claims · 1.8%

Your Cost: $82.69/claim|Median: $75.18
1.1× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$1.3M

24K claims · 1.8%

Your Cost: $54.93/claim|Median: $54.68
1.0× median
76816Top 25%

Ultrasound, pregnant uterus, follow-up

$1.2M

15K claims · 1.7%

Your Cost: $80.88/claim|Median: $58.55
1.4× median
90833Top 25%

Psychotherapy, 30 min, add-on to E/M service

$1.2M

19K claims · 1.6%

Your Cost: $63.68/claim|Median: $38.83
1.6× median
99291Normal range

Critical care, first 30-74 minutes

$1.1M

11K claims · 1.5%

Your Cost: $99.03/claim|Median: $101.24
1.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.1M

15K claims · 1.5%

Your Cost: $73.97/claim|Median: $69.35
1.1× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$848K

5,914 claims · 1.2%

Your Cost: $143.39/claim|Median: $106.79
1.3× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$825K

15K claims · 1.1%

Your Cost: $56.51/claim|Median: $43.85
1.3× median
74177Normal range

CT abdomen and pelvis with contrast

$735K

11K claims · 1.0%

Your Cost: $64.29/claim|Median: $65.76
1.0× median
93010Normal range

Electrocardiogram, interpretation and report only

$733K

147K claims · 1.0%

Your Cost: $4.99/claim|Median: $5.60
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$691K

8,346 claims · 0.9%

Your Cost: $82.81/claim|Median: $74.82
1.1× median
59400Top 25%

Routine obstetric care, vaginal delivery, including postpartum

$664K

303 claims · 0.9%

Your Cost: $2,189.92/claim|Median: $1,482.45
1.5× median
99222Top 25%

Initial hospital care, per day, moderate complexity

$615K

7,981 claims · 0.8%

Your Cost: $77.00/claim|Median: $51.25
1.5× median
99205Top 25%

Office/outpatient visit, new patient, high complexity

$568K

3,692 claims · 0.8%

Your Cost: $153.80/claim|Median: $111.09
1.4× median
90834Normal range

Psychotherapy, 45 minutes

$557K

8,594 claims · 0.8%

Your Cost: $64.84/claim|Median: $63.65
1.0× median
H0005Normal range

Alcohol and/or drug services, group counseling

$525K

17K claims · 0.7%

Your Cost: $31.10/claim|Median: $47.35
0.7× median
71045Normal range

Chest X-ray, single view

$525K

98K claims · 0.7%

Your Cost: $5.33/claim|Median: $4.93
1.1× median
99285Normal range

Emergency dept visit, high/urgent complexity

$447K

4,203 claims · 0.6%

Your Cost: $106.41/claim|Median: $85.65
1.2× median
70450Normal range

CT head/brain without contrast

$376K

14K claims · 0.5%

Your Cost: $26.81/claim|Median: $45.53
0.6× median
70553Normal range

MRI brain without contrast, then with contrast

$360K

4,695 claims · 0.5%

Your Cost: $76.62/claim|Median: $133.68
0.6× median
77067Normal range

Screening mammography, bilateral, including CAD

$326K

11K claims · 0.4%

Your Cost: $29.37/claim|Median: $39.33
0.7× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$324K

24K claims · 0.4%

Your Cost: $13.55/claim|Median: $7.18
1.9× median
95819Normal range

Electroencephalogram with sleep recording

$322K

2,063 claims · 0.4%

Your Cost: $156.18/claim|Median: $62.75
2.5× median
76819Normal range

Fetal biophysical profile with non-stress test

$280K

4,146 claims · 0.4%

Your Cost: $67.49/claim|Median: $49.45
1.4× median
71275Normal range

CT angiography, chest, with contrast

$266K

4,151 claims · 0.4%

Your Cost: $64.16/claim|Median: $92.96
0.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$263K

2,907 claims · 0.4%

Your Cost: $90.49/claim|Median: $80.15
1.1× median
99188Top 25%

$261K

12K claims · 0.4%

Your Cost: $21.19/claim|Median: $12.80
1.7× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$246K

1,580 claims · 0.3%

Your Cost: $155.62/claim|Median: $108.91
1.4× median
90791Normal range

Psychiatric diagnostic evaluation

$230K

1,878 claims · 0.3%

Your Cost: $122.46/claim|Median: $99.21
1.2× median
99212Normal range

Office/outpatient visit, low complexity

$202K

6,741 claims · 0.3%

Your Cost: $30.03/claim|Median: $25.06
1.2× median
76705Normal range

Ultrasound, abdominal, limited

$187K

8,828 claims · 0.3%

Your Cost: $21.22/claim|Median: $23.81
0.9× median
90670Top 25%

$162K

11K claims · 0.2%

Your Cost: $15.02/claim|Median: $5.94
2.5× median
59025Normal range

Fetal non-stress test

$161K

4,315 claims · 0.2%

Your Cost: $37.38/claim|Median: $26.45
1.4× median
64615Normal range

$159K

1,468 claims · 0.2%

Your Cost: $108.15/claim|Median: $82.82
1.3× median
96112Normal range

Developmental test administration

$158K

1,287 claims · 0.2%

Your Cost: $122.92/claim|Median: $102.95
1.2× median
90853Normal range

Group psychotherapy

$155K

7,986 claims · 0.2%

Your Cost: $19.43/claim|Median: $25.02
0.8× median
94010Top 25%

$150K

5,578 claims · 0.2%

Your Cost: $26.93/claim|Median: $18.11
1.5× median
72148Normal range

MRI lumbar spine without contrast

$145K

2,751 claims · 0.2%

Your Cost: $52.68/claim|Median: $101.03
0.5× median
99417Normal range

$143K

3,431 claims · 0.2%

Your Cost: $41.60/claim|Median: $34.90
1.2× median
74018Normal range

$141K

24K claims · 0.2%

Your Cost: $5.97/claim|Median: $7.00
0.9× median

Other Top Providers in Virginia

View all →

Virginia Commonwealth University Health System Authority

General Acute Care Hospital

$658.5M

Rector & Visitors of the University of Virginia

General Acute Care Hospital

$500.5M

Wall Residences LLC

Community Based Residential Treatment Facility In

$481.6M

Home Care Delivered, Inc.

Durable Medical Equipment & Medical Supplies

$309.5M

Childrens Hospital of the Kings Daughters INC

Social Worker, Clinical

$288.2M

Similar Providers

Other top providers in Clinic/Center, Multi-Specialty

Group Health Plan, Inc.

Minneapolis, MN

$204.3M

Banner - University Medical Center Tucson Campus LLC

Tucson, AZ

$194.4M

Wake Forest University Health Sciences

Winston Salem, NC

$188.0M

Barrio Comprehensive Family Health Care Center, Inc.

San Antonio, TX

$148.0M

← All providersAll providers in Virginia →How we detect fraud →