Physician
Children's Health of Carolina, PA
Children's Health of Carolina, PA was paid $4.98M by Medicaid between Jan 2018 and Dec 2024, across 60 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 26% of everything it billed.
33Billing provider infoCHILDREN'S HEALTH OF CAROLINA, PA
RAEFORD, NC 28376
RAEFORD, NC 28376
33aNPI1144284548assigned 04/13/2006
33bProvider typePediatrics Physician
28Total paid$4.98M
24GClaims313,445
24DCodes billed60
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#78 of 433
Median peer was paid$942K
This provider vs. median5.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 23,957 | $587K | |
| 2019 | 23,951 | $703K | |
| 2020 | 13,368 | $432K | |
| 2021 | 65,819 | $908K | |
| 2022 | 51,614 | $413K | |
| 2023 | 74,207 | $1.03M | |
| 2024incomplete | 60,529 | $906K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 26% | 184,233 | 97,354 | $1.27M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 15,850 | 13,858 | $925K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 16% | 8,969 | 7,561 | $776K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.3% | 3,103 | 2,843 | $262K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.8% | 2,840 | 2,499 | $241K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 4.7% | 12,457 | 11,195 | $233K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.2% | 2,176 | 1,918 | $207K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 4.0% | 4,496 | 3,449 | $200K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.8% | 5,153 | 4,612 | $188K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.6% | 2,090 | 1,840 | $181K |
| 87400 | 2.0% | 4,290 | 3,381 | $101K | |
| D0145 | Oral evaluation for a patient under three years of age | 1.9% | 3,027 | 2,782 | $92K |
48 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 5,810 | $72K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,456 | $50K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 4,791 | $43K |
| D1206 | Topical application of fluoride varnish | <1% | 3,030 | $40K |
| 96127 | <1% | 6,089 | $23K | |
| 80061 | Lipid panel | <1% | 861 | $12K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 896 | $7K |
| 85018 | <1% | 8,636 | $6K | |
| 92551 | <1% | 7,101 | $5K | |
| 90474 | <1% | 242 | $5K | |
| 90651 | <1% | 1,086 | $4K | |
| 87807 | <1% | 314 | $4K | |
| 83655 | <1% | 289 | $4K | |
| 96161 | <1% | 846 | $3K | |
| 0071A | <1% | 34 | $2K | |
| 90734 | <1% | 742 | $2K | |
| 0072A | <1% | 31 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 136 | $2K |
| 99070 | <1% | 181 | $2K | |
| 81003 | <1% | 1,190 | $1K | |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 98 | $1K |
| 90686 | <1% | 5,396 | $1K | |
| 94664 | <1% | 93 | $952.21 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 34 | $904.32 |
| 90620 | <1% | 354 | $852.25 | |
| 99173 | <1% | 7,229 | $675.18 | |
| A4627 | Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler | <1% | 18 | $627.68 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 39 | $595.08 |
| 99051 | <1% | 28 | $529.60 | |
| 90688 | <1% | 1,039 | $523.20 | |
| 69210 | <1% | 24 | $520.84 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 73 | $156.60 |
| 90656 | <1% | 226 | $62.49 | |
| 90633 | <1% | 410 | $34.10 | |
| 90670 | 0% | 1,396 | $0.00 | |
| 90681 | 0% | 246 | $0.00 | |
| 90715 | 0% | 69 | $0.00 | |
| 90700 | 0% | 12 | $0.00 | |
| 90707 | 0% | 13 | $0.00 | |
| 90685 | 0% | 87 | $0.00 | |
| 99000 | 0% | 1,770 | $0.00 | |
| 90723 | 0% | 1,036 | $0.00 | |
| 90647 | 0% | 926 | $0.00 | |
| S8110 | Peak expiratory flow rate (physician services) | 0% | 127 | $0.00 |
| 94760 | 0% | 30 | $0.00 | |
| 90677 | 0% | 133 | $0.00 | |
| 90716 | 0% | 13 | $0.00 | |
| 91307 | 0% | 81 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSEALY, LAURA (BUSINESS MANAGER)
Parent organizationCHILDREN'S HEALTH OF CAROLINA PA
| Provider | Location | Paid |
|---|---|---|
| Children's Health of Carolina, PA | Lumberton, NC | $89.47M |
| Children's Health of Carolina, PA | Pembroke, NC | $18.18M |
| Children's Health of Carolina, PA | Fayetteville, NC | $7.66M |
| Children's Health of Carolina, PA | Fairmont, NC | $103K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.