Medicaid Provider Spending

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

CALDWELL MEMORIAL HOSPITAL, INC.

NPI: 1417483728 · LENOIR, NC 28630 · Family Medicine Physician · NPI assigned 05/05/2017

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

Authorized official SHADOWENS, KAREN controls 20+ related entities in our dataset. Read more

$1.44M
Total Medicaid Paid
72,836
Total Claims
59,159
Beneficiaries
16
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSHADOWENS, KAREN (CFO)
Parent OrganizationCALDWELL MEMORIAL HOSPITAL, INC.
NPI Enumeration Date05/05/2017

Related Entities

Other providers sharing the same authorized official: SHADOWENS, KAREN

ProviderCityStateTotal Paid
CALDWELL MEMORIAL HOSPITAL, INC. LENOIR NC $28.83M
UNC ROCKINGHAM HEALTH CARE, INC. EDEN NC $10.35M
CALDWELL MEMORIAL HOSPITAL, INC GRANITE FALLS NC $7.30M
CALDWELL MEMORIAL HOSPITAL, INC LENOIR NC $5.30M
CALDWELL MEMORIAL HOSPITAL, INC LENOIR NC $1.65M
CALDWELL MEMORIAL HOSPITAL, INC. HUDSON NC $1.34M
CALDWELL MEMORIAL HOSPITAL, INC LENOIR NC $861K
CALDWELL MEMORIAL HOSPITAL, INC. LENOIR NC $547K
CALDWELL MEMORIAL HOSPITAL, INC. LENOIR NC $393K
CALDWELL MEMORIAL HOSPITAL, INC LENOIR NC $323K
CALDWELL MEMORIAL HOSPITAL, INC LENOIR NC $289K
HIGHLAND HEALTH PROVIDERS CORP LYNCHBURG OH $251K
CALDWELL MEMORIAL HOSPITAL, INC LENOIR NC $229K
CALDWELL MEMORIAL HOSPITAL INC LENOIR NC $224K
CALDWELL MEMORIAL HOSPITAL, INC. BLOWING ROCK NC $202K
CALDWELL MEMORIAL HOSPITAL, INC. LENOIR NC $177K
CALDWELL MEMORIAL HOSPTIAL, INC LENOIR NC $168K
CALDWELL MEMORIAL HOSPITAL, INC. HUDSON NC $108K
CALDWELL MEMORIAL HOSPITAL, INC. LENOIR NC $82K
CALDWELL MEMORIAL HOSPITAL, INC. LENOIR NC $64K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,635 $153K
2019 4,073 $154K
2020 4,007 $136K
2021 6,879 $205K
2022 15,411 $272K
2023 17,636 $266K
2024 20,195 $253K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 21,161 18,377 $759K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 9,287 8,135 $433K
99199 Unlisted special service, procedure or report 39,229 29,858 $180K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,633 1,354 $28K
99243 178 152 $10K
99051 377 373 $9K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 118 105 $8K
99215 Prolong outpt/office vis 116 105 $7K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 41 40 $2K
90686 269 250 $2K
99244 Office or other outpatient consultation, moderate to high complexity 15 14 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 57 55 $755.50
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 236 233 $351.28
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) 93 83 $219.91
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 13 13 $84.78
3078F 13 12 $0.00