Physician
Caldwell Memorial Hospital, INC
Caldwell Memorial Hospital, INC was paid $7.30M by Medicaid between Jan 2018 and Dec 2024, across 48 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.
33Billing provider infoCALDWELL MEMORIAL HOSPITAL, INC
GRANITE FALLS, NC 28630
GRANITE FALLS, NC 28630
33aNPI1689881831assigned 05/17/2007
33bProvider typePediatrics Physician
28Total paid$7.30M
24GClaims333,687
24DCodes billed48
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#57 of 433
Median peer was paid$942K
This provider vs. median7.7×
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.
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 | 30,426 | $772K | |
| 2019 | 29,866 | $974K | |
| 2020 | 21,262 | $705K | |
| 2021 | 41,966 | $1.25M | |
| 2022 | 75,433 | $1.41M | |
| 2023 | 72,993 | $1.27M | |
| 2024incomplete | 61,741 | $921K |
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 | 39% | 71,108 | 58,898 | $2.87M |
| 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 | 12% | 13,830 | 11,319 | $893K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.3% | 7,536 | 6,511 | $677K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 8.3% | 14,331 | 12,372 | $607K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.0% | 6,934 | 5,537 | $580K |
| 99199 | Unlisted special service, procedure or report | 7.4% | 132,931 | 106,400 | $541K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.7% | 5,390 | 4,645 | $490K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.6% | 1,836 | 1,603 | $188K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.2% | 10,210 | 8,699 | $86K |
| 96127 | 1.0% | 21,190 | 17,482 | $75K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 2,134 | 1,652 | $55K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,246 | 2,642 | $53K |
36 more codes
| D0145 | Oral evaluation for a patient under three years of age | <1% | 1,281 | $43K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 595 | $32K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 289 | $22K |
| 99051 | <1% | 785 | $19K | |
| D1206 | Topical application of fluoride varnish | <1% | 1,247 | $16K |
| 96161 | <1% | 3,328 | $8K | |
| 92551 | <1% | 5,900 | $7K | |
| 99173 | <1% | 8,412 | $7K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 249 | $5K |
| 99401 | <1% | 226 | $5K | |
| 99442 | <1% | 92 | $3K | |
| 90474 | <1% | 232 | $3K | |
| 90686 | <1% | 5,765 | $3K | |
| 90651 | <1% | 390 | $3K | |
| 90734 | <1% | 386 | $2K | |
| 99381 | <1% | 17 | $1K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 181 | $757.08 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 13 | $652.08 |
| 90670 | <1% | 3,863 | $651.00 | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 123 | $645.99 |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 710 | $635.18 |
| 90715 | <1% | 72 | $160.17 | |
| 92552 | <1% | 1,808 | $145.43 | |
| 96160 | <1% | 32 | $98.25 | |
| 90680 | <1% | 1,562 | $97.06 | |
| 90723 | <1% | 2,042 | $93.33 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 30 | $66.56 |
| 90633 | <1% | 694 | $32.86 | |
| 90647 | 0% | 2,050 | $0.00 | |
| 99000 | 0% | 75 | $0.00 | |
| 90677 | 0% | 204 | $0.00 | |
| 90656 | 0% | 284 | $0.00 | |
| 90696 | 0% | 12 | $0.00 | |
| 90685 | 0% | 37 | $0.00 | |
| 90710 | 0% | 13 | $0.00 | |
| 94642 | 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 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 | 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 | $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.