Physician
Carolina Spine, Pain and Rehabilitation PLLC
Carolina Spine, Pain and Rehabilitation PLLC was paid $1.29M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is 64483, — 28% of everything it billed.
33Billing provider infoCAROLINA SPINE, PAIN AND REHABILITATION PLLC
GASTONIA, NC 28054
GASTONIA, NC 28054
33aNPI1134185184assigned 04/26/2006
33bProvider typePhysical Medicine & Rehabilitation Physician
28Total paid$1.29M
24GClaims60,354
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Physical Medicine & Rehabilitation Physician providers in North Carolina
Rank by total paid#7 of 42
Median peer was paid$18K
This provider vs. median73×
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.
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 | 9,963 | $200K | |
| 2019 | 9,595 | $199K | |
| 2020 | 9,834 | $186K | |
| 2021 | 8,587 | $178K | |
| 2022 | 9,198 | $215K | |
| 2023 | 7,886 | $150K | |
| 2024incomplete | 5,291 | $158K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 64483 | 28% | 4,718 | 3,279 | $363K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 9,764 | 8,199 | $248K |
| 64484 | 14% | 4,648 | 3,225 | $181K | |
| 95886 | 9.4% | 2,505 | 1,754 | $121K | |
| 95910 | 6.2% | 1,062 | 892 | $79K | |
| 62321 | 5.3% | 912 | 677 | $68K | |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 4.5% | 10,930 | 7,584 | $58K |
| 95911 | 3.7% | 565 | 492 | $48K | |
| 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 | 2.7% | 1,510 | 1,136 | $34K |
| 20611 | 2.1% | 947 | 637 | $27K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.0% | 552 | 455 | $25K |
| 64493 | <1% | 335 | 226 | $9K |
16 more codes
| 77002 | <1% | 267 | $5K | |
| 64494 | <1% | 333 | $4K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,083 | $4K |
| 64495 | <1% | 315 | $4K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 389 | $3K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 43 | $2K |
| J3490 | Unclassified drugs | <1% | 4,019 | $1K |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 2,048 | $816.78 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 288 | $122.00 |
| 1125F | 0% | 3,638 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 3,136 | $0.00 |
| 1036F | 0% | 236 | $0.00 | |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 1,066 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 1,373 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 2,492 | $0.00 |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 180 | $0.00 |
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 officialGORE, HERMAN (CEO)