Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $673K by Medicaid between Jan 2018 and Aug 2024, across 35 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 30% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
LINCOLNTON, NC 28092
LINCOLNTON, NC 28092
33aNPI1023328309assigned 10/20/2010
33bProvider typeGynecology Physician
28Total paid$673K
24GClaims33,666
24DCodes billed35
24AFirst – last monthJan 2018 – Aug 2024
Compared with peers
Next to other Gynecology Physician providers in North Carolina
Rank by total paid#3 of 16
Median peer was paid$40K
This provider vs. median17×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official RISSMILLER, SCOTT controls 20+ related entities in our dataset. Read more
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 | 4,193 | $97K | |
| 2019 | 3,956 | $110K | |
| 2020 | 2,609 | $100K | |
| 2021 | 5,978 | $119K | |
| 2022 | 10,539 | $210K | |
| 2023 | 4,599 | $27K | |
| 2024incomplete | 1,792 | $9K |
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 | 30% | 4,379 | 3,437 | $201K |
| 99199 | Unlisted special service, procedure or report | 11% | 12,753 | 6,950 | $73K |
| 59025 | Fetal non-stress test | 7.4% | 1,765 | 1,198 | $50K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | 7.2% | 31 | 26 | $49K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 7.0% | 640 | 585 | $47K |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | 5.8% | 351 | 247 | $39K |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | 4.0% | 669 | 553 | $27K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 4.0% | 281 | 240 | $27K |
| 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 | 3.0% | 320 | 248 | $20K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 2.9% | 561 | 403 | $19K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.7% | 818 | 484 | $18K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 2.4% | 248 | 192 | $16K |
23 more codes
| 81025 | 2.4% | 2,701 | $16K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.3% | 1,294 | $15K |
| 99203 | Doctor's office visit, new patient (routine) | 2.1% | 192 | $14K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.4% | 138 | $10K |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,076 | $7K |
| 76830 | Ultrasound, transvaginal | <1% | 70 | $6K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 749 | $5K |
| 85027 | <1% | 751 | $4K | |
| 59430 | <1% | 77 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 159 | $2K |
| 99442 | <1% | 40 | $1K | |
| 76813 | <1% | 15 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 134 | $857.99 |
| 90715 | <1% | 26 | $803.31 | |
| 87210 | <1% | 178 | $701.72 | |
| 90686 | <1% | 38 | $446.85 | |
| 82950 | <1% | 31 | $156.88 | |
| 80053 | Comprehensive metabolic panel | <1% | 13 | $93.99 |
| 96127 | <1% | 19 | $60.83 | |
| 1159F | 0% | 39 | $0.00 | |
| 98966 | 0% | 57 | $0.00 | |
| 3074F | 0% | 37 | $0.00 | |
| 99024 | 0% | 16 | $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 officialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent organizationCAROLINAS PHYSICIANS NETWORK INC
| Provider | Location | Paid |
|---|---|---|
| Carolinas Medical Center | Charlotte, NC | $52.97M |
| Cotswold Family Medicine | Charlotte, NC | $12.51M |
| Carolinas Physicians Network INC. | Charlotte, NC | $8.93M |
| Carolinas Physicians Network INC | Gastonia, NC | $8.57M |
| Carolinas Physicians Network INC | Rock Hill, SC | $8.47M |
| University Pediatrics | Charlotte, NC | $8.22M |
| Carolinas Medical Center | Charlotte, NC | $6.42M |
| Eastland Urgent Care | Charlotte, NC | $5.05M |
| Carolinas Physicians Network INC | Charlotte, NC | $4.24M |
| University Pediatrics | Charlotte, NC | $3.22M |
| Carolinas Physicians Network INC | Fort Mill, SC | $3.04M |
| Carolinas Physicians Network INC | Concord, NC | $2.91M |
| Carolinas Medical Center | Charlotte, NC | $2.82M |
| Charlotte Pediatric Clinic | Charlotte, NC | $2.46M |
| Carolinas Physicians Network INC | Concord, NC | $2.38M |
| Pediatric Endocrinology & Diabetes Specialists | Charlotte, NC | $2.27M |
| Carolinas Physicians Network INC | Charlotte, NC | $2.06M |
| Carolinas Physicians Network INC | Kannapolis, NC | $1.98M |
| Arboretum Pediatrics | Charlotte, NC | $1.92M |
| Carolinas Physicians Network INC | Charlotte, NC | $1.91M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.