Medicaid Provider Spending

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

CALDWELL MEMORIAL HOSPITAL, INC

NPI: 1417962150 · LENOIR, NC 28645 · Internal Medicine Physician · NPI assigned 07/30/2006

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

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

$861K
Total Medicaid Paid
67,758
Total Claims
58,711
Beneficiaries
10
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSHADOWENS, KAREN (CFO)
Parent OrganizationCALDWELL MEMORIAL HOSPITAL, INC.
NPI Enumeration Date07/30/2006

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. LENOIR NC $1.44M
CALDWELL MEMORIAL HOSPITAL, INC. HUDSON NC $1.34M
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 469 $12K
2019 2,394 $70K
2020 5,066 $126K
2021 8,591 $76K
2022 21,679 $192K
2023 16,394 $176K
2024 13,165 $209K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 10,843 9,228 $395K
99199 Unlisted special service, procedure or report 48,057 41,721 $190K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,086 3,506 $188K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,222 3,750 $73K
99215 Prolong outpt/office vis 170 143 $12K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 16 16 $914.42
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) 138 125 $588.17
90686 64 62 $261.75
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 136 134 $222.90
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 26 26 $66.45