Medicaid spending in North Carolina

1. Agencies — home care, case management, community support
   36¢
2. Physicians
   13¢
3. Counselors, therapists and social workers
   8¢
4. Laboratories
   8¢
5. Clinics and outpatient centers
   6¢
6. Hospitals (outpatient claims only)
   6¢
7. Dentists
   6¢
8. Medical equipment and supplies
   4¢

Cents of every dollar billed by North Carolina-based providers, grouped by each provider's primary NPPES type. Compare: nationally, agencies take 33¢ and physicians 11¢.

1. 99509Home visit for assistance with activities of daily living and personal care
   $3.4B
2. T2013Habilitation, educational, waiver; per hour
   $1.7B
3. 99214Doctor's office visit, returning patient (more involved)
   $1.2B
4. S5125Attendant care at home, billed per 15 minutes
   $1.2B
5. T1000Private duty / independent nursing service(s) - licensed, up to 15 minutes
   $1.2B
6. 99199Unlisted special service, procedure or report
   $943M
7. T2021Day program for adults with developmental disabilities, per 15 minutes
   $935M
8. 99213Doctor's office visit, returning patient (routine)
   $909M
9. 99284Emergency room visit (serious)
   $868M
10. H2022Community-based wrap-around services, per diem
    $717M

Statistical outliers on claims per beneficiary, single-code billing, and OIG exclusion. Not evidence of fraud — how these work.