Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $4.63M by Medicaid between Jan 2018 and Dec 2024, across 59 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 33% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
RUTHERFORDTON, NC 28139
RUTHERFORDTON, NC 28139
33aNPI1073881694assigned 12/09/2011
33bProvider typePediatric Adolescent Medicine Physician
28Total paid$4.63M
24GClaims263,407
24DCodes billed59
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Adolescent Medicine Physician providers in North Carolina
Rank by total paid#10 of 20
Median peer was paid$4.16M
This provider vs. median1.1×
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 | 19,981 | $508K | |
| 2019 | 22,884 | $734K | |
| 2020 | 15,590 | $473K | |
| 2021 | 34,443 | $705K | |
| 2022 | 53,694 | $773K | |
| 2023 | 56,362 | $718K | |
| 2024incomplete | 60,453 | $722K |
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 | 33% | 23,897 | 20,580 | $1.52M |
| 99199 | Unlisted special service, procedure or report | 14% | 113,044 | 68,945 | $628K |
| 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 | 12% | 5,843 | 5,245 | $536K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.9% | 3,768 | 3,262 | $320K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.4% | 3,140 | 2,763 | $298K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.9% | 2,416 | 2,167 | $228K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.8% | 9,425 | 8,211 | $174K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.2% | 4,889 | 4,184 | $150K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.1% | 1,417 | 1,231 | $146K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.0% | 3,272 | 2,868 | $139K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 2.5% | 1,810 | 1,668 | $114K |
| 85027 | 1.3% | 7,915 | 6,943 | $59K |
47 more codes
| D0145 | Oral evaluation for a patient under three years of age | 1.1% | 1,496 | $52K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 3,879 | $52K |
| 96127 | <1% | 10,232 | $43K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,814 | $32K |
| D1206 | Topical application of fluoride varnish | <1% | 1,486 | $23K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 342 | $16K |
| 90651 | <1% | 645 | $15K | |
| 96160 | <1% | 3,671 | $13K | |
| 90474 | <1% | 854 | $12K | |
| 80061 | Lipid panel | <1% | 739 | $12K |
| 83655 | <1% | 629 | $9K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,749 | $8K |
| 96161 | <1% | 2,469 | $8K | |
| 92551 | <1% | 5,047 | $3K | |
| 90734 | <1% | 428 | $3K | |
| 87807 | <1% | 239 | $3K | |
| 90686 | <1% | 4,250 | $3K | |
| 81003 | <1% | 1,830 | $2K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 75 | $2K |
| 99051 | <1% | 81 | $2K | |
| 99381 | <1% | 26 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 85 | $2K |
| 99173 | <1% | 5,193 | $1K | |
| 99442 | <1% | 25 | $1K | |
| 0072A | <1% | 26 | $926.64 | |
| 0071A | <1% | 19 | $892.40 | |
| 90677 | <1% | 441 | $867.09 | |
| 90633 | <1% | 841 | $865.83 | |
| 90620 | <1% | 27 | $794.78 | |
| 90715 | <1% | 123 | $557.71 | |
| 94010 | <1% | 16 | $383.70 | |
| 90670 | <1% | 2,571 | $224.49 | |
| 88720 | <1% | 34 | $149.52 | |
| 36416 | <1% | 1,796 | $34.76 | |
| 99177 | <1% | 135 | $7.83 | |
| 1159F | <1% | 7,287 | $0.17 | |
| 1160F | 0% | 4,499 | $0.00 | |
| 3078F | 0% | 3,094 | $0.00 | |
| 90710 | 0% | 197 | $0.00 | |
| 90700 | 0% | 14 | $0.00 | |
| 3008F | 0% | 560 | $0.00 | |
| 90723 | 0% | 1,863 | $0.00 | |
| 90647 | 0% | 1,899 | $0.00 | |
| 90680 | 0% | 1,273 | $0.00 | |
| 3074F | 0% | 3,226 | $0.00 | |
| 90656 | 0% | 308 | $0.00 | |
| 91307 | 0% | 38 | $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.