Physician
Caldwell Memorial Hospital, INC.
Caldwell Memorial Hospital, INC. was paid $1.44M by Medicaid between Jan 2018 and Dec 2024, across 16 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 53% of everything it billed.
33Billing provider infoCALDWELL MEMORIAL HOSPITAL, INC.
LENOIR, NC 28630
LENOIR, NC 28630
33aNPI1417483728assigned 05/05/2017
33bProvider typeFamily Medicine Physician
28Total paid$1.44M
24GClaims72,836
24DCodes billed16
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in North Carolina
Rank by total paid#95 of 960
Median peer was paid$135K
This provider vs. median11×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official SHADOWENS, KAREN controls 20+ related entities in our dataset. Read more
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 | 4,635 | $153K | |
| 2019 | 4,073 | $154K | |
| 2020 | 4,007 | $136K | |
| 2021 | 6,879 | $205K | |
| 2022 | 15,411 | $272K | |
| 2023 | 17,636 | $266K | |
| 2024incomplete | 20,195 | $253K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 53% | 21,161 | 18,377 | $759K |
| 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 | 30% | 9,287 | 8,135 | $433K |
| 99199 | Unlisted special service, procedure or report | 13% | 39,229 | 29,858 | $180K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.0% | 1,633 | 1,354 | $28K |
| 99243 | <1% | 178 | 152 | $10K | |
| 99051 | <1% | 377 | 373 | $9K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 118 | 105 | $8K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 116 | 105 | $7K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 41 | 40 | $2K |
| 90686 | <1% | 269 | 250 | $2K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 15 | 14 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 57 | 55 | $755.50 |
4 more codes
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 236 | $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) | <1% | 93 | $219.91 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | $84.78 |
| 3078F | 0% | 13 | $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 officialSHADOWENS, KAREN (CFO)
Parent organizationCALDWELL MEMORIAL HOSPITAL, INC.
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.