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CHILDREN'S HEALTH OF CAROLINA, PA

Pediatrics·LUMBERTON, NC·NPI: 1598729014Share

Compared to Pediatrics Peers

Total spending distribution among 14 providers in this specialty

P25MedianP75P90

This provider's total spending of $89.5M is at the 25th percentile among 14 Pediatrics providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$89.5M

$89,466,018

Total Claims

7.3M

Beneficiaries

6.1M

1.2 claims/patient

Avg Cost/Claim

$12

Monthly Spending Trend

Yearly Spending

2018
$3.8M
+18%
2019
$4.4M
-7%
2020
$4.1M
+258%
2021
$14.8M
+76%
2022
$26.1M
-3%
2023
$25.3M
-57%
2024
$10.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99199 (Unlisted special service, procedure, or report)) accounts for 51% of total spending.

99199Top 25%

Unlisted special service, procedure, or report

$45.6M

5.8M claims · 51.0%

Your Cost: $7.83/claim|Median: $5.39
1.5× median
99213Top 25%

Office/outpatient visit, est. patient, low-mod complexity

$14.5M

248K claims · 16.2%

Your Cost: $58.25/claim|Median: $37.81
1.5× median
U0002Top 25%

COVID-19 lab test, non-CDC, nucleic acid

$4.4M

94K claims · 4.9%

Your Cost: $46.86/claim|Median: $34.62
1.4× median
99214Top 25%

Office/outpatient visit, est. patient, mod-high complexity

$3.9M

45K claims · 4.3%

Your Cost: $86.20/claim|Median: $53.41
1.6× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$3.1M

34K claims · 3.4%

Your Cost: $89.46/claim|Median: $75.18
1.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$2.8M

33K claims · 3.1%

Your Cost: $83.79/claim|Median: $69.35
1.2× median
87400Top 25%

$2.2M

92K claims · 2.5%

Your Cost: $23.96/claim|Median: $8.40
2.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$2.1M

24K claims · 2.3%

Your Cost: $87.82/claim|Median: $74.82
1.2× median
90472Top 5%

Immunization administration, each additional vaccine

$2.0M

53K claims · 2.2%

Your Cost: $36.74/claim|Median: $11.79
3.1× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$1.7M

17K claims · 1.9%

Your Cost: $95.60/claim|Median: $80.15
1.2× median
90471Top 25%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$1.6M

88K claims · 1.8%

Your Cost: $18.77/claim|Median: $9.80
1.9× median
99051Top 25%

$1.2M

52K claims · 1.4%

Your Cost: $23.82/claim|Median: $7.89
3.0× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$979K

77K claims · 1.1%

Your Cost: $12.75/claim|Median: $11.48
1.1× median
96110Normal range

Developmental screening, per standardized instrument

$377K

39K claims · 0.4%

Your Cost: $9.77/claim|Median: $9.10
1.1× median
99212Top 25%

Office/outpatient visit, low complexity

$371K

10K claims · 0.4%

Your Cost: $37.03/claim|Median: $25.06
1.5× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$361K

11K claims · 0.4%

Your Cost: $33.47/claim|Median: $57.30
0.6× median
87807Top 25%

$222K

17K claims · 0.2%

Your Cost: $12.75/claim|Median: $10.06
1.3× median
99222Top 10%

Initial hospital care, per day, moderate complexity

$174K

1,646 claims · 0.2%

Your Cost: $105.88/claim|Median: $51.25
2.1× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$165K

42K claims · 0.2%

Your Cost: $3.88/claim|Median: $3.67
1.1× median
D1206Normal range

Topical application of fluoride varnish

$161K

11K claims · 0.2%

Your Cost: $14.70/claim|Median: $18.12
0.8× median
99232Top 1%

Subsequent hospital care, per day, moderate complexity

$151K

1,254 claims · 0.2%

Your Cost: $120.40/claim|Median: $23.99
5.0× median
99203Top 25%

Office/outpatient visit, new patient, low-mod complexity

$150K

1,863 claims · 0.2%

Your Cost: $80.76/claim|Median: $57.85
1.4× median
90474Top 10%

$145K

7,608 claims · 0.2%

Your Cost: $19.11/claim|Median: $8.42
2.3× median
83655Top 25%

$110K

8,031 claims · 0.1%

Your Cost: $13.75/claim|Median: $10.49
1.3× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$98K

1,695 claims · 0.1%

Your Cost: $57.60/claim|Median: $37.22
1.5× median
90651Normal range

HPV vaccine, 9-valent

$90K

8,885 claims · 0.1%

Your Cost: $10.15/claim|Median: $8.93
1.1× median
80061Top 25%

Lipid panel

$84K

5,656 claims · 0.1%

Your Cost: $14.79/claim|Median: $8.41
1.8× median
92551Normal range

Screening audiometry, pure tone, air only

$79K

57K claims · 0.1%

Your Cost: $1.39/claim|Median: $6.61
0.2× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$78K

9,230 claims · 0.1%

Your Cost: $8.46/claim|Median: $4.71
1.8× median
E0570Top 5%

Nebulizer, with compressor

$71K

541 claims · 0.1%

Your Cost: $130.74/claim|Median: $16.16
8.1× median
85018Normal range

$70K

60K claims · 0.1%

Your Cost: $1.17/claim|Median: $1.71
0.7× median
96161Normal range

$62K

18K claims · 0.1%

Your Cost: $3.34/claim|Median: $2.49
1.3× median
A4627Top 25%

$47K

1,319 claims · 0.1%

Your Cost: $35.81/claim|Median: $21.89
1.6× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$41K

364 claims · 0.0%

Your Cost: $111.56/claim|Median: $72.71
1.5× median
90734Normal range

$32K

6,458 claims · 0.0%

Your Cost: $4.98/claim|Median: $6.40
0.8× median
99050Top 25%

$29K

1,103 claims · 0.0%

Your Cost: $26.37/claim|Median: $11.81
2.2× median
88720Top 25%

$26K

5,214 claims · 0.0%

Your Cost: $4.96/claim|Median: $3.88
1.3× median
81025Normal range

Urine pregnancy test

$19K

2,900 claims · 0.0%

Your Cost: $6.51/claim|Median: $4.81
1.4× median
81003Normal range

Urinalysis, automated without microscopy

$17K

8,743 claims · 0.0%

Your Cost: $1.96/claim|Median: $1.48
1.3× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$15K

1,188 claims · 0.0%

Your Cost: $12.81/claim|Median: $9.56
1.3× median
99211Normal range

Office/outpatient visit, minimal complexity

$15K

846 claims · 0.0%

Your Cost: $17.93/claim|Median: $12.93
1.4× median
99383Top 25%

Preventive visit, new patient, late childhood (5-11 yr)

$14K

143 claims · 0.0%

Your Cost: $99.37/claim|Median: $81.92
1.2× median
A7006Top 25%

$14K

1,636 claims · 0.0%

Your Cost: $8.43/claim|Median: $5.66
1.5× median
90620Normal range

$12K

2,484 claims · 0.0%

Your Cost: $4.98/claim|Median: $6.49
0.8× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$12K

28K claims · 0.0%

Your Cost: $0.45/claim|Median: $7.18
0.1× median
0071ATop 10%

$11K

195 claims · 0.0%

Your Cost: $56.19/claim|Median: $38.71
1.5× median
0072ATop 10%

$10K

176 claims · 0.0%

Your Cost: $55.81/claim|Median: $39.57
1.4× median
17110Normal range

Destruction of benign lesions, up to fourteen

$9K

124 claims · 0.0%

Your Cost: $69.42/claim|Median: $59.25
1.2× median
87804Top 10%

Influenza virus detection, rapid test

$8K

302 claims · 0.0%

Your Cost: $27.93/claim|Median: $12.59
2.2× median
83036Top 25%

Hemoglobin A1c (glycated hemoglobin)

$8K

824 claims · 0.0%

Your Cost: $9.20/claim|Median: $5.50
1.7× median

Other Top Providers in North Carolina

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Laboratory Corporation of America Holdings

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$1.44B

Aeroflow INC

Durable Medical Equipment & Medical Supplies

$571.7M

Abound Health, LLC

In Home Supportive Care

$324.3M

Laboratory Corporation of America Holdings

Clinical Medical Laboratory

$281.4M

Laboratory Corporation of America Holdings

Clinical Medical Laboratory

$264.3M

Similar Providers

Other top providers in Pediatrics

Legacy Community Health Services, INC

Houston, TX

$406.5M

Saltzman Tanis Pittell Levin and Jacobson

Hollywood, FL

$201.3M

Children's Specialized Hospital

New Brunswick, NJ

$199.9M

Phoenix Children's Hospital

Phoenix, AZ

$162.4M

Texas Children's Physician Group

Houston, TX

$160.8M

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