Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

NC#16 of 49 states

North Carolina Medicaid Spending

North Carolina's Medicaid program paid $4.59B across 16 providers from 2018–2024. 22 providers in North Carolina are flagged on our risk watchlist. The top procedure code is T2013 (Habilitation, residential, waiver, per hour) at $341.2M.

Total Spending

$4.59B

Total Claims

159.0M

Top Providers

16

Beneficiaries

132.2M

Top Procedure

T2013

$341.2M

Flagged Providers

22

on risk watchlist

Avg Per Provider

$287.2M

across 16 providers

Yearly Spending Trend

Spending by Top Procedures

T2013Habilitation, residential, waiver, per hour$341.2M
U0003Infectious disease detection (COVID-19)$291.5M
81420Fetal chromosomal aneuploidy genomic sequence analysis$191.4M
T2012Habilitation, educational; per 15 min$187.8M
99284Emergency dept visit, high complexity$176.8M

Top Procedures in North Carolina

CodeTotal Paid
T2013

Habilitation, residential, waiver, per hour

$341.2M
U0003

Infectious disease detection (COVID-19)

$291.5M
81420

Fetal chromosomal aneuploidy genomic sequence analysis

$191.4M
T2012

Habilitation, educational; per 15 min

$187.8M
99284

Emergency dept visit, high complexity

$176.8M
T2021

Day habilitation, waiver; per 15 min

$156.2M
99283

Emergency dept visit, moderate complexity

$131.3M
87491

Chlamydia detection, nucleic acid, amplified probe

$101.0M
80307

Drug test, presumptive, by chemistry analyzers

$100.5M
87591

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$94.7M
97153

Adaptive behavior treatment by protocol, per 15 min

$92.6M
H2016

Comprehensive community support services, per 15 min

$85.8M
E0603

Breast pump, electric, any type

$84.4M
87798

Infectious agent detection, nucleic acid, not otherwise specified

$84.3M
S5135

Companion care, adult, per diem

$75.4M