HOOVER MCGY ROYALS, M.D.
NPI 1093851891, individual, Dover, NC, Family Medicine
- Hours beyond a day in 2 months, but with up to 626 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2022 | More hours than a day holds at a conservative unit price | 9.0 | 44.3 | 29.5 | 43.6 | 622 | 1 | 99308 99309 | $50K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 8.4 | 44.4 | 29.6 | 41.7 | 514 | 1 | 99308 99309 | $41K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | HOOVER MCGY ROYALS, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | January 29, 2007, last updated December 31, 2022 |
| Practice location | 235 JENKINS RD, Dover, NC 28526, 252-259-6467 |
| Mailing address | 740 GREENVILLE BLVD SE, STE 400 - 337, Greenville, NC 27858-5221 |
| Specialties | Family Medicine (207Q00000X, primary, license 30718 NC) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $1.2M | 68% | $53 | $21 (top 5% from $84) | 88th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $518K | 31% | $41 | $14 (top 5% from $58) | 90th percentile | |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | $18K | 1% | $68 | $22 (top 5% from $71) | too few months to rank | |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $4K | 0% | $9.87 | $5.69 (top 5% from $25) | 84th percentile | |
| 80051 | Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) | $2K | 0% | $8.38 | $0.35 (top 5% from $22) | 89th percentile | |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | $2K | 0% | $16 | $9.74 (top 5% from $20) | 89th percentile | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $1K | 0% | $28 | $22 (top 5% from $33) | too few months to rank | |
| 83036 | Hemoglobin a1c level | $1K | 0% | $12 | $5.87 (top 5% from $14) | 90th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 2,287 | 591 | $168K | $150 | $106 | 1.4x | 2.0x (90th percentile 3.3x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 1,237 | 485 | $63K | $125 | $74 | 1.7x | 2.0x (90th percentile 3.4x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
2 providers in Craven County, NC carry an indicator in the public record, with $1.2M at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | CENTURY CARE OF NEW BERN, INC. New Bern, NC, ranked 6322 | $0 |
|
| 4 | SAMANTHA CRISTE Dover, NC, ranked 8932 | $1.2M |
|
Recent enforcement in NC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.