VICENTE JOSE HILL, MD

NPI 1578527636, individual, Franklin, NC, Emergency Medicine

Evidence tier

structure or single-organization volume

Hours beyond a day in 2 months under one organization, which can be supervisory billing.
Records needed.
Medicaid dollars per patient on code 99408 ($206 per patient-month) sit in the top 5% of every provider billing that code.

score 54 of 100, rank 8001, $279K at stake

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
Feb 2019	More hours than a day holds, even counting one unit per claim line	27.3	20.3	13.5	18.9	242	1	99408	$62K
Mar 2019	More hours than a day holds, even counting one unit per claim line	27.1	21.8	14.6	21.5	239	1	99408	$74K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	VICENTE JOSE HILL, MD
Type	Individual
Status	Active
NPI issued	April 14, 2006, last updated September 8, 2022
Practice location	RIVERVIEW WHITE OAK ST, Franklin, NC 28734, 843-237-3378
Mailing address	PO BOX 1856, Pawleys Island, SC 29585-1856
Specialties	Emergency Medicine (207P00000X, primary, license 200100697 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
99408	Alcohol/substance screening and brief intervention 15-30 min	$492K	24%	$206	$0.49 (top 5% from $42)	98th percentile
99285	Emergency department visit with high level of medical decision making	$297K	15%	$136	$100 (top 5% from $264)	76th percentile
99284	Emergency department visit with moderate level of medical decision making	$247K	12%	$113	$86 (top 5% from $224)	72nd percentile
99211	Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	$242K	12%	$75	$16 (top 5% from $128)	89th percentile
82075	Measurement of alcohol level in breath specimen	$212K	10%	$16	$29 (top 5% from $75)	25th percentile
99283	Emergency department visit with low level of medical decision making	$140K	7%	$82	$60 (top 5% from $193)	64th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$108K	5%	$63	$44 (top 5% from $110)	75th percentile
74177	Ct scan of abdomen and pelvis with contrast	$28K	1%	$916	$59 (top 5% from $362)	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
99285	Emergency department visit with high level of medical decision making	201	195	$27K	$955	$172	5.6x	6.9x (90th percentile 11.7x)
99284	Emergency department visit with moderate level of medical decision making	265	261	$24K	$356	$118	3.0x	6.7x (90th percentile 11.3x)
99283	Emergency department visit with low level of medical decision making	69	68	$4K	$216	$70	3.1x	5.8x (90th percentile 10.9x)
99291	Critical care, first 30-74 minutes	17	17	$3K	$1K	$211	5.8x	4.7x (90th percentile 10.0x)

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

167 providers in NC carry an indicator in the public record, with $185.5M at stake between them. The most common is more hours than a day holds, on 84 of them, followed by part of a provider network on 42. 22 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	DAVID SMITH Winston Salem, NC, ranked 2	$1.1M	Listed on the Medicare revocation list and the SC Medicaid exclusion list since August 30, 2021. Medicaid still paid claims in 7 later months, $1,063,751 in total. and 1 more
1	MICHAEL ADIX Shelby, NC, ranked 12	$155K	Listed on the Medicare revocation list since April 18, 2023. Medicaid still paid claims in 11 later months, $154,645 in total. and 1 more
1	CAROLINA FAMILY AND URGENT CARE Lumberton, NC, ranked 30	$6K	Listed on the Medicare revocation list since September 8, 2023. Medicaid still paid claims in 7 later months, $5,787 in total. and 1 more
1	JOSEPH MEYER Fort Bragg, NC, ranked 48	$26K	Listed on the Medicare revocation list since October 20, 2006. Medicaid still paid claims in 7 later months, $26,252 in total. and 1 more
1	LIFE TOUCH LLC Kinston, NC, ranked 68	$868K	Adjudicated (charged, pleaded guilty, sentenced) per a Department of Justice release dated June 30, 2025. Medicaid paid $868,112 in the last 12 observed months.
1	ULTIMATE SACRIFICE Winston Salem, NC, ranked 96	$365K	Adjudicated (pleaded guilty) per a Department of Justice release dated April 9, 2025. Medicaid paid $364,787 in the last 12 observed months.
1	MALIK MUHAMMAD Durham, NC, ranked 116	$2K	Listed on the Medicare revocation list since October 12, 2021. Medicaid still paid claims in 1 later month, $1,779 in total. and 1 more
1	JACKSON CONSULTING AND SERVICES LLC Charlotte, NC, ranked 127	$138K	Adjudicated (sentenced) per a Department of Justice release dated August 27, 2026. Medicaid paid $137,561 in the last 12 observed months.

All 167 in NC

Recent enforcement in NC

All releases

Department 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

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