Physician
Children's Health of Carolina, PA
Children's Health of Carolina, PA was paid $18.18M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 29% of everything it billed.
33Billing provider infoCHILDREN'S HEALTH OF CAROLINA, PA
PEMBROKE, NC 28372
PEMBROKE, NC 28372
33aNPI1750345286assigned 04/13/2006
33bProvider typePediatrics Physician
28Total paid$18.18M
24GClaims974,917
24DCodes billed80
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#11 of 433
Median peer was paid$942K
This provider vs. median19×
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 | 49,829 | $1.49M | |
| 2019 | 52,821 | $1.78M | |
| 2020 | 47,003 | $1.75M | |
| 2021 | 156,517 | $3.17M | |
| 2022 | 266,288 | $3.81M | |
| 2023 | 236,041 | $3.76M | |
| 2024incomplete | 166,418 | $2.42M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29% | 90,984 | 73,979 | $5.29M |
| 99199 | Unlisted special service, procedure or report | 17% | 530,778 | 311,685 | $3.11M |
| 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 | 9.3% | 19,535 | 15,704 | $1.70M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.7% | 13,719 | 11,907 | $1.22M |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 5.7% | 23,476 | 18,126 | $1.04M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.6% | 12,137 | 10,070 | $1.01M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.1% | 8,336 | 7,081 | $744K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.7% | 17,870 | 15,574 | $671K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.1% | 5,888 | 5,004 | $563K |
| 87400 | 2.8% | 24,843 | 16,786 | $516K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.8% | 27,140 | 23,651 | $512K |
| D0145 | Oral evaluation for a patient under three years of age | 1.4% | 7,611 | 6,617 | $260K |
68 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 19,865 | $252K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.4% | 6,708 | $251K |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | 1.2% | 889 | $227K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 15,925 | $144K |
| D1206 | Topical application of fluoride varnish | <1% | 7,849 | $116K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 8,572 | $76K |
| 87807 | <1% | 5,230 | $63K | |
| 90474 | <1% | 2,917 | $57K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,394 | $51K |
| 83655 | <1% | 3,287 | $44K | |
| 80061 | Lipid panel | <1% | 2,776 | $40K |
| E0570 | Nebulizer, with compressor | <1% | 229 | $30K |
| 95117 | <1% | 3,400 | $29K | |
| 96161 | <1% | 7,599 | $25K | |
| 92551 | <1% | 15,007 | $22K | |
| 96127 | <1% | 5,161 | $20K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 158 | $14K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,214 | $11K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 100 | $10K |
| 95024 | <1% | 143 | $10K | |
| 81025 | <1% | 879 | $6K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 30 | $5K |
| A7006 | Administration set, with small volume filtered pneumatic nebulizer | <1% | 521 | $5K |
| 99381 | <1% | 76 | $4K | |
| 81003 | <1% | 1,683 | $4K | |
| 0071A | <1% | 104 | $3K | |
| 82962 | <1% | 1,129 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 80 | $2K |
| 85018 | <1% | 1,092 | $2K | |
| 88720 | <1% | 394 | $2K | |
| 99173 | <1% | 16,885 | $2K | |
| 90651 | <1% | 2,493 | $2K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 26 | $2K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 138 | $1K |
| 99070 | <1% | 162 | $1K | |
| 90734 | <1% | 2,023 | $1K | |
| 99051 | <1% | 52 | $1K | |
| 90620 | <1% | 818 | $1K | |
| A4627 | Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler | <1% | 28 | $1K |
| 99401 | <1% | 54 | $802.47 | |
| 90677 | <1% | 872 | $798.07 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 196 | $756.02 |
| 90656 | <1% | 150 | $629.44 | |
| 94664 | <1% | 40 | $385.77 | |
| 94760 | <1% | 7,491 | $299.53 | |
| 94010 | <1% | 12 | $281.38 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 227 | $140.03 |
| 90686 | <1% | 3,671 | $104.26 | |
| 90723 | <1% | 6,984 | $97.04 | |
| 86308 | <1% | 12 | $71.14 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 29 | $70.20 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 13 | $68.32 |
| 90633 | <1% | 4,699 | $35.80 | |
| 90647 | <1% | 6,764 | $29.83 | |
| 90715 | <1% | 575 | $0.01 | |
| 90707 | 0% | 1,008 | $0.00 | |
| 90670 | 0% | 8,447 | $0.00 | |
| 90710 | 0% | 743 | $0.00 | |
| 90700 | 0% | 651 | $0.00 | |
| 90681 | 0% | 3,031 | $0.00 | |
| J7510 | Prednisolone oral, per 5 mg | 0% | 13 | $0.00 |
| 90685 | 0% | 123 | $0.00 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 0% | 350 | $0.00 |
| 90716 | 0% | 1,115 | $0.00 | |
| 99000 | 0% | 2,139 | $0.00 | |
| S8110 | Peak expiratory flow rate (physician services) | 0% | 3,412 | $0.00 |
| 90696 | 0% | 621 | $0.00 | |
| 91307 | 0% | 122 | $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 | 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.