Medicaid Provider Spending

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

FORSYTH MEMORIAL HOSPITAL, INC

NPI: 1295783108 · MOUNT AIRY, NC 27030 · Family Medicine Physician · NPI assigned 05/04/2006

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

Authorized official WALTON, LEEA controls 20+ related entities in our dataset. Read more

$3.23M
Total Medicaid Paid
174,232
Total Claims
157,784
Beneficiaries
76
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialWALTON, LEEA (RCS MANAGER)
NPI Enumeration Date05/04/2006

Related Entities

Other providers sharing the same authorized official: WALTON, LEEA

ProviderCityStateTotal Paid
NOVANT HEALTH MEDICAL GROUP, LLC MONROE NC $8.57M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $5.75M
NOVANT HEALTH MEDICAL GROUP, LLC MATTHEWS NC $4.57M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $3.45M
NOVANT HEALTH MEDICAL GROUP, LLC SHALLOTTE NC $3.02M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $2.83M
FORSYTH MEMORIAL HOSPITAL INC KING NC $2.46M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $2.35M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $2.30M
FORSYTH MEMORIAL HOSPITAL INC YADKINVILLE NC $2.23M
NOVANT HEALTH MEDICAL GROUP, LLC SALISBURY NC $2.10M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $2.07M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $2.02M
NOVANT HEALTH MEDICAL GROUP, LLC CORNELIUS NC $1.95M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $1.87M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $1.82M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $1.66M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $1.33M
NOVANT HEALTH MEDICAL GROUP, LLC CHARLOTTE NC $1.29M
NOVANT HEALTH MEDICAL GROUP, LLC HUNTERSVILLE NC $1.20M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 20,631 $448K
2019 20,216 $552K
2020 14,943 $448K
2021 26,068 $627K
2022 37,510 $693K
2023 29,491 $389K
2024 25,373 $72K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 24,174 20,723 $1.41M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 2,906 2,532 $267K
99199 Unlisted special service, procedure or report 77,905 76,375 $249K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 2,760 2,455 $238K
90460 Immunization administration through 18 years of age via any route, first or only component 4,285 3,580 $212K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,937 1,636 $175K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,311 2,082 $104K
99443 1,213 952 $86K
99215 Prolong outpt/office vis 501 390 $63K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 621 509 $59K
90834 Psychotherapy, 45 minutes with patient 1,339 809 $56K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 3,704 1,826 $51K
96110 Developmental screening, with scoring and documentation, per standardized instrument 4,231 3,557 $40K
90472 Immunization administration, each additional vaccine (list separately) 1,018 979 $35K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,735 1,660 $34K
96127 6,543 5,316 $28K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 2,026 1,766 $19K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 233 179 $15K
96160 3,928 3,325 $14K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 995 962 $13K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 276 202 $13K
96161 2,859 2,328 $11K
90461 2,734 2,316 $10K
90474 301 289 $6K
87807 343 311 $4K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 240 172 $4K
99442 59 48 $3K
36415 Collection of venous blood by venipuncture 1,105 908 $3K
90686 1,179 1,069 $2K
80053 Comprehensive metabolic panel 162 144 $2K
90791 Psychiatric diagnostic evaluation 20 18 $1K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 46 38 $1K
81003 865 802 $937.04
81001 348 315 $754.59
99173 3,452 2,954 $628.67
90734 63 45 $441.00
83036 Hemoglobin; glycosylated (A1C) 23 18 $213.69
90674 158 122 $117.52
92552 153 145 $9.00
92551 21 19 $3.00
90698 1,139 1,032 $0.00
G9717 Documentation stating the patient has had a diagnosis of bipolar disorder 382 346 $0.00
3017F 158 146 $0.00
G8536 No documentation of an elder maltreatment screen, reason not given 587 511 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 678 615 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 511 453 $0.00
1036F 750 686 $0.00
90744 405 372 $0.00
90680 917 843 $0.00
G9902 Patient screened for tobacco use and identified as a tobacco user 147 122 $0.00
G8432 Depression screening not documented, reason not given 527 472 $0.00
90723 46 38 $0.00
1101F 185 164 $0.00
1123F 32 25 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 16 14 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 30 25 $0.00
G8926 Spirometry test not performed or documented, reason not given 15 13 $0.00
G8541 Functional outcome assessment using a standardized tool not documented, reason not given 1,973 1,790 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 316 289 $0.00
4004F 188 160 $0.00
90670 2,143 1,899 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 2,182 1,978 $0.00
G8509 Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given 491 434 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 208 196 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 24 24 $0.00
90633 243 207 $0.00
G8482 Influenza immunization administered or previously received 284 265 $0.00
G8442 Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter 313 293 $0.00
90648 201 173 $0.00
G8484 Influenza immunization was not administered, reason not given 205 178 $0.00
90700 26 26 $0.00
G8399 Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed 13 12 $0.00
1090F 46 40 $0.00
4040F 48 39 $0.00
99401 17 14 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 14 14 $0.00