Physician
Children's Health of Carolina, PA
Children's Health of Carolina, PA was paid $89.47M by Medicaid between Jan 2018 and Dec 2024, across 93 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 51% of everything it billed.
33Billing provider infoCHILDREN'S HEALTH OF CAROLINA, PA
LUMBERTON, NC 28358
LUMBERTON, NC 28358
33aNPI1598729014assigned 04/13/2006
33bProvider typePediatrics Physician
28Total paid$89.47M
24GClaims7,257,110
24DCodes billed93
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#1 of 433
Median peer was paid$942K
This provider vs. median95×
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 | 148,385 | $3.78M | |
| 2019 | 144,339 | $4.45M | |
| 2020 | 134,592 | $4.14M | |
| 2021 | 1,157,562 | $14.83M | |
| 2022 | 2,450,580 | $26.05M | |
| 2023 | 2,396,833 | $25.30M | |
| 2024incomplete | 824,819 | $10.92M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 51% | 5,831,723 | 4,861,345 | $45.65M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 248,377 | 205,101 | $14.47M |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 4.9% | 93,766 | 74,619 | $4.39M |
| 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 | 4.3% | 45,039 | 37,706 | $3.88M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.4% | 34,425 | 30,150 | $3.08M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.1% | 33,421 | 27,776 | $2.80M |
| 87400 | 2.5% | 91,610 | 70,077 | $2.19M | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.3% | 23,763 | 20,635 | $2.09M |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.2% | 53,359 | 46,278 | $1.96M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.9% | 17,489 | 14,897 | $1.67M |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.8% | 87,793 | 75,910 | $1.65M |
| 99051 | 1.4% | 52,022 | 43,992 | $1.24M |
81 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 76,824 | $979K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 38,582 | $377K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 10,022 | $371K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 10,780 | $361K |
| 87807 | <1% | 17,379 | $222K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 1,646 | $174K |
| 96127 | <1% | 42,487 | $165K | |
| D1206 | Topical application of fluoride varnish | <1% | 10,975 | $161K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 1,254 | $151K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,863 | $150K |
| 90474 | <1% | 7,608 | $145K | |
| 83655 | <1% | 8,031 | $110K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 1,695 | $98K |
| 90651 | <1% | 8,885 | $90K | |
| 80061 | Lipid panel | <1% | 5,656 | $84K |
| 92551 | <1% | 57,033 | $79K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 9,230 | $78K |
| E0570 | Nebulizer, with compressor | <1% | 541 | $71K |
| 85018 | <1% | 60,021 | $70K | |
| 96161 | <1% | 18,423 | $62K | |
| A4627 | Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler | <1% | 1,319 | $47K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 364 | $41K |
| 90734 | <1% | 6,458 | $32K | |
| 99050 | <1% | 1,103 | $29K | |
| 88720 | <1% | 5,214 | $26K | |
| 81025 | <1% | 2,900 | $19K | |
| 81003 | <1% | 8,743 | $17K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,188 | $15K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 846 | $15K |
| 99383 | <1% | 143 | $14K | |
| A7006 | Administration set, with small volume filtered pneumatic nebulizer | <1% | 1,636 | $14K |
| 90620 | <1% | 2,484 | $12K | |
| 90686 | <1% | 27,697 | $12K | |
| 0071A | <1% | 195 | $11K | |
| 0072A | <1% | 176 | $10K | |
| 17110 | <1% | 124 | $9K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 302 | $8K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 824 | $8K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 100 | $6K |
| 99242 | <1% | 85 | $6K | |
| 94664 | <1% | 578 | $6K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 37 | $4K |
| 99173 | <1% | 56,795 | $4K | |
| 90677 | <1% | 3,388 | $4K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 361 | $3K |
| 99382 | <1% | 32 | $3K | |
| 90715 | <1% | 1,761 | $3K | |
| 99384 | <1% | 15 | $2K | |
| 99070 | <1% | 232 | $2K | |
| 99401 | <1% | 55 | $2K | |
| 99219 | <1% | 14 | $2K | |
| 94760 | <1% | 24,188 | $1K | |
| 99217 | <1% | 18 | $1K | |
| 90633 | <1% | 11,047 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 367 | $778.78 |
| 94010 | <1% | 31 | $716.24 | |
| 69210 | <1% | 21 | $664.52 | |
| 90656 | <1% | 1,209 | $619.39 | |
| 90723 | <1% | 18,236 | $576.75 | |
| 87210 | <1% | 190 | $540.30 | |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 28 | $406.90 |
| 90688 | <1% | 943 | $327.00 | |
| 90716 | <1% | 2,594 | $288.94 | |
| 96381 | <1% | 19 | $222.00 | |
| 86308 | <1% | 35 | $217.68 | |
| 96380 | <1% | 21 | $171.86 | |
| 90647 | <1% | 18,093 | $119.32 | |
| 90681 | <1% | 7,658 | $94.75 | |
| 90707 | <1% | 2,491 | $82.66 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 117 | $59.71 |
| 82962 | <1% | 18 | $34.68 | |
| 99000 | 0% | 13,088 | $0.00 | |
| 91307 | 0% | 452 | $0.00 | |
| 36416 | 0% | 383 | $0.00 | |
| 90696 | 0% | 1,699 | $0.00 | |
| 90381 | 0% | 34 | $0.00 | |
| 90670 | 0% | 21,573 | $0.00 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 0% | 289 | $0.00 |
| 90700 | 0% | 1,924 | $0.00 | |
| 90685 | 0% | 1,728 | $0.00 | |
| 90710 | 0% | 1,725 | $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 | Pembroke, NC | $18.18M |
| Children's Health of Carolina, PA | Fayetteville, NC | $7.66M |
| Children's Health of Carolina, PA | Raeford, NC | $4.98M |
| 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.