North Carolina's 16,856 Medicaid providers billed $34.82B between 2018 and 2024. The most-billed code is 99509, accounting for $3.35B in payments. Charlotte is the largest Medicaid billing hub in the state. 9 providers in NC appear on the OIG exclusion list.
| Code | Description | Total Paid |
|---|---|---|
| 99509 | Home visit for assistance with activities of daily living and personal care | $3.35B |
| T2013 | Habilitation, educational, waiver; per hour | $1.74B |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $1.20B |
CHARLOTTE ($3.83B) RALEIGH ($2.26B) BURLINGTON ($2.07B) GREENSBORO ($1.79B) FAYETTEVILLE ($1.07B) DURHAM ($1.06B) GREENVILLE ($1.06B) WINSTON SALEM ($1.06B) GASTONIA ($895.42M) WILMINGTON ($861.69M) ASHEVILLE ($835.96M) MINT HILL ($629.39M) ARDEN ($617.42M) LUMBERTON ($588.13M) CONCORD ($514.07M) WILSON ($477.25M) RESEARCH TRIANGLE PARK ($453.40M) HICKORY ($434.24M) GOLDSBORO ($386.41M) ROCKY MOUNT ($365.12M) SHELBY ($336.69M) MONROE ($335.15M) STATESVILLE ($327.68M) LENOIR ($303.60M) HIGH POINT ($293.84M) WHITEVILLE ($272.79M) KINSTON ($270.77M) JACKSONVILLE ($265.07M) SALISBURY ($236.54M) MORGANTON ($235.33M) CHAPEL HILL ($230.40M) MOORESVILLE ($224.73M) NEW BERN ($221.14M) CARY ($209.45M) MARION ($192.79M) RAEFORD ($190.82M) ROANOKE RAPIDS ($185.52M) PEMBROKE ($183.66M) SANFORD ($179.54M) ASHEBORO ($176.90M) PINEHURST ($172.60M) HENDERSON ($168.86M) FOREST CITY ($162.14M) ALBEMARLE ($161.41M) AHOSKIE ($159.98M) HENDERSONVILLE ($159.22M) DUNN ($157.40M) LAURINBURG ($154.79M) GARNER ($154.60M) SMITHFIELD ($153.75M)
Automated signals based on claims-per-beneficiary ratios, single-code concentration, and OIG exclusion status. These are statistical outliers — not evidence of fraud. Learn more
| # | Provider | Total Paid | Flags |
|---|---|---|---|
| 1 | SMOKY MOUNTAIN CENTER FOR MH/DD/SAS | $51.51M | single-code billing |
| 2 | LUTHERAN FAMILY SERVICES | $35.28M | single-code billing |
| 3 | HAIRE ENTERPRISES, LLC | $22.72M | single-code billing |
| 4 | PERSONAL HOME CARE OF NORTH CAROLINA, LLC | $21.05M | single-code billing |
| 5 | BARIUM SPRINGS HOME FOR CHILDREN | $19.26M | single-code billing |
| 6 | DURHAM RIDGE ASSISTED LIVING | $18.55M | single-code billing |
| 7 | THE BAIR FOUNDATION | $17.32M | single-code billing |
| 8 | PEDIATRIC SERVICES OF AMERICA, LLC | $15.59M | single-code billing |
| 9 | A PRIMARY CHOICE | $15.53M | single-code billing |
| 10 | PEDIATRIC SERVICES OF AMERICA, LLC | $15.07M | single-code billing |
| 11 | INTERIM HEALTHCARE - MORRIS GROUP, INC. | $14.90M | single-code billing |
| 12 | PREMIER HOMECARE. LLC | $14.39M | single-code billing |
| 13 | METROCORP AFFILIATES, LTD | $14.29M | single-code billing |
| 14 | PEDIATRIC SERVICES OF AMERICA, LLC | $14.20M | single-code billing |
| 15 | PHILLIPS HOME HEALTH CARE AGENCY | $13.80M | single-code billing |
| 16 | RHA BEHAVIORAL HEALTH NC LLC | $12.56M | single-code billing |
| 17 | MORGAN SUPPORT SERVICES, INC. | $12.52M | single-code billing |
| 18 | FOUR OAKS OPCO HOLDINGS, LLC | $10.98M | single-code billing |
| 19 | SUNRISE HOME CARE INC | $10.96M | single-code billing |
| 20 | INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, INC | $10.84M | single-code billing |
| 21 | OMNI FAMILY OF SERVICES NORTH CAROLINA INC. | $10.72M | single-code billing |
| 22 | RVHI,LLC | $10.69M | single-code billing |
| 23 | DUDLEY'S HOME HEALTH, INC. | $10.65M | single-code billing |
| 24 | PFC CORPORATION | $10.28M | single-code billing |
| 25 | PREMIER HOMECARE, LLC | $10.15M | single-code billing |