Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1073881694 · RUTHERFORDTON, NC 28139 · Pediatric Adolescent Medicine Physician · NPI assigned 12/09/2011

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official RISSMILLER, SCOTT controls 20+ related entities in our dataset. Read more

$4.63M
Total Medicaid Paid
263,407
Total Claims
200,384
Beneficiaries
59
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date12/09/2011

Related Entities

Other providers sharing the same authorized official: RISSMILLER, SCOTT

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 19,981 $508K
2019 22,884 $734K
2020 15,590 $473K
2021 34,443 $705K
2022 53,694 $773K
2023 56,362 $718K
2024 60,453 $722K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 23,897 20,580 $1.52M
99199 Unlisted special service, procedure or report 113,044 68,945 $628K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 5,843 5,245 $536K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3,768 3,262 $320K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,140 2,763 $298K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,416 2,167 $228K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 9,425 8,211 $174K
90472 Immunization administration, each additional vaccine (list separately) 4,889 4,184 $150K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1,417 1,231 $146K
90460 Immunization administration through 18 years of age via any route, first or only component 3,272 2,868 $139K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 1,810 1,668 $114K
85027 7,915 6,943 $59K
D0145 Oral evaluation for a patient under three years of age 1,496 1,296 $52K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 3,879 3,545 $52K
96127 10,232 8,886 $43K
96110 Developmental screening, with scoring and documentation, per standardized instrument 6,814 5,924 $32K
D1206 Topical application of fluoride varnish 1,486 1,289 $23K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 342 281 $16K
90651 645 616 $15K
96160 3,671 3,309 $13K
90474 854 653 $12K
80061 Lipid panel 739 658 $12K
83655 629 556 $9K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1,749 1,669 $8K
96161 2,469 2,108 $8K
92551 5,047 4,546 $3K
90734 428 383 $3K
87807 239 216 $3K
90686 4,250 3,818 $3K
81003 1,830 1,653 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 75 74 $2K
99051 81 78 $2K
99381 26 26 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 85 59 $2K
99173 5,193 4,614 $1K
99442 25 19 $1K
0072A 26 13 $926.64
0071A 19 16 $892.40
90677 441 435 $867.09
90633 841 775 $865.83
90620 27 27 $794.78
90715 123 111 $557.71
94010 16 15 $383.70
90670 2,571 2,180 $224.49
88720 34 25 $149.52
36416 1,796 1,322 $34.76
99177 135 133 $7.83
1159F 7,287 6,179 $0.17
1160F 4,499 4,018 $0.00
3078F 3,094 2,685 $0.00
90710 197 180 $0.00
90700 14 12 $0.00
3008F 560 542 $0.00
90723 1,863 1,602 $0.00
90647 1,899 1,620 $0.00
90680 1,273 1,038 $0.00
3074F 3,226 2,802 $0.00
90656 308 294 $0.00
91307 38 17 $0.00