Payments to Providers

Medicaid Payments to Providers reports, required by North Carolina Session Law 2014-100 Section 12H.15(a), include the following Medicaid claims provider data:

  • Name of the individual providing the service.
  • Location of provided services, listed with both municipality and county.
  • Practice name, hospital name, or other business name.
  • Type of service provider and practice area.
  • Number of Medicaid patients seen.
  • Number of visits with Medicaid patients.
  • Number of procedures performed or items furnished for Medicaid patients.
  • Amount of Medicaid service payments received.

Requested in the law but not included are supplemental and settlement payments to providers. Because these payments are processed outside of the Medicaid claims system, they will be published later in a separate report.

The information is being published in both Excel and character-separated values (CSV) plain text formats so that the data may easily be imported into software used for spreadsheets, databases, and data analytics.

Reports and Dashboard

Report Notes

  • State Fiscal Years are July 1 through June 30
  • Claim payments are based on payment date to the provider (not date of service).
  • Medicaid claims only (Health Choice not included)
  • Where applicable recipient totals less than 11 and paid amounts less than $10,000 have been removed for privacy concerns.
  • Medicaid supplemental payments and settlement payments are excluded because they are not processed within the Medicaid claims system. They will be listed later in a separate report.
  • “Unknown” county names are due to missing provider information in NCTracks.