Medicare provider payments and utilization data for North Carolina (NC)
North Carolina received $27.9B in total Medicare provider payments across 10 years of data.
The top specialty by spending is Clinical Laboratory, accounting for $318.2M in payments across 104 providers.
In 2023, 40.2K providers were actively billing Medicare in North Carolina.
AI-generated analysis based on Medicare payment data.
Providers in this state flagged by the ML v2 fraud detection model
| Year | Payments | Services | Providers | YoY Change |
|---|---|---|---|---|
| 2014 | $2.6B | 91.0M | 30.6K | — |
| 2015 | $2.8B | 92.1M | 31.8K | +4.5% |
| 2016 | $2.8B | 90.4M | 33.2K | +1.1% |
| 2017 | $2.9B | 89.4M | 34.7K | +2.9% |
| 2018 | $2.9B | 90.8M | 35.5K | -0.3% |
| 2019 | $2.9B | 95.1M | 36.8K | +2.8% |
| 2020 | $2.7B | 85.2M | 37.0K | -8.6% |
| 2021 | $2.9B | 88.7M | 38.5K | +8.5% |
| 2022 | $2.7B | 85.5M | 39.2K | -7.3% |
| 2023 | $2.7B | 86.9M | 40.2K | -0.6% |
| Code | Description | Payments | Services | Providers |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | $273.0M | 3.5M | 18.1K |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | $116.0M | 2.1M | 16.3K |
| J0178 | Injection, aflibercept, 1 mg | $86.3M | 125.6K | 98 |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $55.0M | 145.5K | 144 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $46.2M | 787.8K | 5.7K |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | $43.9M | 392.2K | 5.7K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $43.6M | 366.6K | 4.2K |
| 66984 | Removal of cataract with insertion of prosthetic lens | $43.1M | 608.2K | 584 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $42.8M | 484.6K | 4.2K |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | $40.8M | 389.6K | 8.4K |
| 99285 | Emergency department visit with high level of medical decision making | $37.3M | 286.3K | 2.2K |
| J2777 | Injection, faricimab-svoa, 0.1 mg | $35.3M | 1.2M | 70 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $29.9M | 237.5K | 4.6K |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $28.1M | 404.0K | 899 |
| J0897 | Injection, denosumab, 1 mg | $27.5M | 1.5M | 431 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $27.5M | 1.6M | 2.5K |
| J0129 | Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) | $26.7M | 798.3K | 68 |
| A0425 | Ground mileage, per statute mile | $26.2M | 3.5M | 180 |
| 99291 | Critical care, first 30-74 minutes | $24.5M | 152.8K | 2.6K |
| 80053 | Blood test, comprehensive group of blood chemicals | $23.1M | 2.2M | 1.4K |
| Specialty | Payments | Providers | Avg per Provider |
|---|---|---|---|
| Clinical Laboratory | $318.2M | 104 | $3.1M |
| Ophthalmology | $229.6M | 490 | $468.7K |
| Internal Medicine | $181.1M | 2.4K | $74.3K |
| Nurse Practitioner | $160.7M | 6.3K | $25.7K |
| Family Practice | $141.0M | 2.6K | $53.3K |
| Physician Assistant | $136.4M | 5.6K | $24.2K |
| Ambulance Service Provider | $133.4M | 187 | $713.4K |
| Ambulatory Surgical Center | $105.3M | 128 | $822.8K |
| Diagnostic Radiology | $95.0M | 1.0K | $94.8K |
| Rheumatology | $84.7M | 162 | $522.8K |
| Physical Therapist in Private Practice | $79.4M | 2.3K | $34.4K |
| Dermatology | $76.6M | 391 | $195.9K |
| Cardiology | $76.1M | 570 | $133.4K |
| Orthopedic Surgery | $65.6M | 735 | $89.3K |
| Emergency Medicine | $52.9M | 1.4K | $37.0K |
| Hematology-Oncology | $48.8M | 324 | $150.7K |
| Mass Immunizer Roster Biller | $44.5M | 1.1K | $42.2K |
| Hospitalist | $38.8M | 882 | $44.0K |
| Nephrology | $33.8M | 282 | $119.8K |
| Neurology | $32.1M | 467 | $68.8K |
| Gastroenterology | $30.4M | 463 | $65.7K |
| Urology | $29.0M | 295 | $98.4K |
| Radiation Oncology | $29.0M | 158 | $183.6K |
| Optometry | $28.7M | 922 | $31.1K |
| Physical Medicine and Rehabilitation | $26.8M | 236 | $113.8K |
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.