Physician
Carolinas Pain Institute, PA
Carolinas Pain Institute, PA was paid $1.71M by Medicaid between Jan 2018 and Dec 2024, across 48 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 59% of everything it billed.
33Billing provider infoCAROLINAS PAIN INSTITUTE, PA
WINSTON SALEM, NC 27103
WINSTON SALEM, NC 27103
33aNPI1376598268assigned 05/23/2006
33bProvider typePain Medicine Physician
28Total paid$1.71M
24GClaims87,423
24DCodes billed48
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pain Medicine Physician providers in North Carolina
Rank by total paid#4 of 17
Median peer was paid$197K
This provider vs. median8.7×
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 | 21,248 | $245K | |
| 2019 | 19,197 | $237K | |
| 2020 | 9,475 | $177K | |
| 2021 | 8,914 | $241K | |
| 2022 | 7,163 | $282K | |
| 2023 | 11,382 | $268K | |
| 2024incomplete | 10,044 | $260K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 59% | 30,290 | 26,165 | $1.02M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 14% | 5,180 | 4,421 | $248K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 9.3% | 1,904 | 1,491 | $159K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.7% | 3,622 | 3,220 | $97K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 5.0% | 1,723 | 1,573 | $85K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 3.0% | 826 | 720 | $51K |
| 99442 | 1.8% | 1,699 | 1,353 | $30K | |
| 99443 | <1% | 508 | 404 | $11K | |
| 62323 | <1% | 65 | 58 | $5K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 73 | 56 | $2K |
| 96132 | <1% | 112 | 106 | $2K | |
| 96130 | <1% | 111 | 104 | $973.79 |
36 more codes
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 483 | $924.05 |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | <1% | 108 | $462.02 |
| 96138 | <1% | 112 | $435.10 | |
| 99441 | <1% | 27 | $99.70 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 103 | $30.69 |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | <1% | 92 | $21.11 |
| G8509 | Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given | 0% | 2,290 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 974 | $0.00 |
| 4004F | 0% | 2,385 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 11,795 | $0.00 |
| G9900 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified | 0% | 379 | $0.00 |
| G8541 | Functional outcome assessment using a standardized tool not documented, reason not given | 0% | 5,096 | $0.00 |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 2,122 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 183 | $0.00 |
| G8421 | Bmi not documented and no reason is given | 0% | 173 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 63 | $0.00 |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 147 | $0.00 |
| G9899 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed | 0% | 25 | $0.00 |
| G9905 | Patient not screened for tobacco use | 0% | 86 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 43 | $0.00 |
| G8432 | Depression screening not documented, reason not given | 0% | 3,635 | $0.00 |
| 1036F | 0% | 1,680 | $0.00 | |
| G9717 | Documentation stating the patient has had a diagnosis of bipolar disorder | 0% | 863 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 987 | $0.00 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 1,200 | $0.00 |
| 3017F | 0% | 2,678 | $0.00 | |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 184 | $0.00 |
| G9906 | Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) | 0% | 202 | $0.00 |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | 0% | 901 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 424 | $0.00 |
| G8732 | No documentation of pain assessment, reason not given | 0% | 1,475 | $0.00 |
| G8536 | No documentation of an elder maltreatment screen, reason not given | 0% | 282 | $0.00 |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 12 | $0.00 |
| 1101F | 0% | 56 | $0.00 | |
| G8756 | No documentation of blood pressure measurement, reason not given | 0% | 33 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 12 | $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 officialRAUCK, RICHARD (PRESIDENT)