Providers
ROBERT MCLAIN ADAMS, MD
NPI 1275693517, individual, Wilmington, NC, Psychiatry & Neurology, Child & Adolescent Psychiatry
5
Evidence tier
informational
- Medicaid dollars per patient on code 99233 ($346 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 10067, $1.2M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ROBERT MCLAIN ADAMS, MD |
| Type | Individual |
| Status | Active |
| NPI issued | December 9, 2006, last updated July 28, 2010 |
| Practice location | 710 MILITARY CUTOFF RD, SUITE 120, Wilmington, NC 28405-2375, 910-254-4818 |
| Specialties | Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, primary, license 2007-01359 NC) Psychiatry & Neurology, Psychiatry (2084P0800X, license 2007-01359 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.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $1.3M | 50% | $346 | $96 (top 5% from $249) | 98th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $615K | 24% | $145 | $67 (top 5% from $174) | 91st percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $328K | 13% | $163 | $81 (top 5% from $170) | 94th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $187K | 7% | $92 | $49 (top 5% from $101) | 92nd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $106K | 4% | $56 | $44 (top 5% from $110) | 67th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $59K | 2% | $83 | $60 (top 5% from $133) | 73rd percentile | |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | $1K | 0% | $37 | $37 (top 5% from $103) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 113 | 39 | $7K | $125 | $74 | 1.7x | 2.6x (90th percentile 4.3x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 73 | 23 | $6K | $125 | $112 | 1.1x | 2.6x (90th percentile 4.7x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 26 | 26 | $3K | $200 | $163 | 1.2x | 3.0x (90th percentile 5.6x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 69 | 35 | $3K | $82 | $81 | 1.0x | 2.2x (90th percentile 3.8x) |
| 99239 | Hospital discharge day management, more than 30 minutes | 23 | 22 | $2K | $200 | $107 | 1.9x | 2.8x (90th percentile 5.6x) |
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
3 providers in New Hanover County, NC carry an indicator in the public record, with $4.6M at stake between them. The most common is more hours than a day holds, on 3 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | KANDIE TITO Wilmington, NC, ranked 7541 | $3.2M |
|
| 4 | DOROTHY AGBAFE-MOSLEY Wilmington, NC, ranked 7794 | $1.2M |
|
| 5 | KAREN TALBERT Wilmington, NC, ranked 11521 | $157K |
Recent enforcement in NC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedAug 27, 2026
Charlotte Woman Sentenced for Defrauding the North Carolina Medicaid Program
Jackson and her company submitted over $1.9 million in claims to NC Medicaid for urine drug testing and psychotherapy services that were never performed or already paid, using Medicaid recipients' personal information, and she spent the proceeds.
DOJPleaded guiltyJul 9, 2026
Guilford County Woman Pleads Guilty to Health Care Fraud in Connection with Million Dollar Urine Drug Testing Scheme
Singleton owned and operated Joelle's Center of Hope, which submitted approximately $1,735,865 in claims to North Carolina Medicaid for urine drug tests that were not performed, listing a nurse practitioner and a doctor as ordering providers who never ordered the tests.
DOJPleaded guiltyJun 24, 2026
Raleigh Man Pleads Guilty to Receiving More than $60 Million in Fraudulent Claims from Paying Kickbacks for Patient Referrals
Price owned and operated Golden Star Labs, which paid collectors on a per-specimen basis to supply bogus respiratory test samples obtained through identity theft, and billed Medi-Cal and Medicare more than $96 million in false claims, receiving more than $60 million, and he also filed a false federal income tax return.
DOJChargedJun 24, 2026
McLeansville Woman Charged With Health Care Fraud, Part of National Health Care Fraud Takedown
White, the owner of Reginald Center of Turn Around, billed North Carolina Medicaid for thousands of fictitious drug tests resulting in a loss of $2.8 million.
DOJIndictedJun 24, 2026
Felon Indicted in Multimillion Dollar Healthcare Kickback and False Documents Conspiracy
Ayyad is alleged to have solicited and received kickbacks from clinical laboratories in exchange for generating referrals, paid kickbacks to independent contractor sales reps, created dozens of sham invoices and contracts to conceal the payments, and caused the submission of fraudulent claims for laboratory testing to Medicare, HRSA, TRICARE, and other payers through labs and entities he owned and controlled.
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.