Managed care
Carolina Pediatrics
Carolina Pediatrics was paid $3.38M by Medicaid between Jan 2018 and Dec 2024, across 32 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 32% of everything it billed.
33Billing provider infoCAROLINA PEDIATRICS
WILMINGTON, NC 28401
WILMINGTON, NC 28401
33aNPI1346201340assigned 03/29/2006
33bProvider typePoint of Service
28Total paid$3.38M
24GClaims290,023
24DCodes billed32
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Point of Service providers in North Carolina
Rank by total paid#1 of 6
Median peer was paid$2.00M
This provider vs. median1.7×
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 | 9,033 | $267K | |
| 2019 | 8,897 | $333K | |
| 2020 | 6,616 | $217K | |
| 2021 | 28,772 | $407K | |
| 2022 | 74,486 | $767K | |
| 2023 | 78,583 | $717K | |
| 2024incomplete | 83,636 | $673K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 32% | 218,367 | 97,718 | $1.08M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 18,792 | 13,585 | $881K |
| 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 | 15% | 7,878 | 5,485 | $498K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.3% | 3,120 | 2,476 | $247K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 5.8% | 11,468 | 8,956 | $196K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 4.6% | 4,993 | 3,912 | $155K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.4% | 1,939 | 1,413 | $147K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.7% | 1,210 | 949 | $91K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 3,976 | 3,128 | $28K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 216 | 165 | $19K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,439 | 530 | $14K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 969 | 695 | $10K |
20 more codes
| 87428 | <1% | 77 | $4K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 117 | $3K |
| 90686 | <1% | 3,342 | $3K | |
| 87081 | <1% | 387 | $2K | |
| 99173 | <1% | 2,306 | $1K | |
| 92551 | <1% | 830 | $1K | |
| 96127 | <1% | 211 | $868.81 | |
| 99051 | <1% | 31 | $662.00 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 19 | $648.21 |
| 90670 | <1% | 827 | $456.64 | |
| 90671 | <1% | 72 | $221.80 | |
| 85018 | <1% | 84 | $188.50 | |
| 90656 | <1% | 256 | $41.02 | |
| 3008F | <1% | 6,558 | $3.50 | |
| 90633 | 0% | 35 | $0.00 | |
| 90681 | 0% | 18 | $0.00 | |
| 90723 | 0% | 196 | $0.00 | |
| 90647 | 0% | 255 | $0.00 | |
| 90677 | 0% | 15 | $0.00 | |
| 91307 | 0% | 20 | $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 officialFOREHAND, MARY (MANAGING PARTNER)