Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1235148529 · ROCK HILL, SC 29732 · Pediatrics Physician · NPI assigned 08/05/2006

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

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

$8.47M
Total Medicaid Paid
204,454
Total Claims
198,673
Beneficiaries
52
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date08/05/2006

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
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
CHARLOTTE PEDIATRIC CLINIC MATTHEWS NC $1.76M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 27,460 $1.07M
2019 29,817 $1.19M
2020 26,067 $985K
2021 27,820 $1.12M
2022 27,891 $1.15M
2023 33,234 $1.43M
2024 32,165 $1.51M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 33,300 32,030 $2.76M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 35,868 34,332 $2.10M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 12,560 11,835 $978K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 9,820 9,719 $833K
90460 Immunization administration through 18 years of age via any route, first or only component 28,620 28,223 $738K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 3,808 3,777 $338K
90461 10,175 10,040 $203K
96110 Developmental screening, with scoring and documentation, per standardized instrument 14,456 14,208 $110K
96127 11,695 11,402 $89K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 861 848 $84K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 953 936 $53K
G9153 Mapcp demonstration - physician incentive pool 452 452 $34K
96161 3,768 3,662 $29K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 315 301 $24K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 782 771 $24K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,280 1,262 $17K
99215 Prolong outpt/office vis 119 117 $15K
85018 4,718 4,661 $11K
83655 441 439 $5K
99177 1,303 1,279 $5K
90834 Psychotherapy, 45 minutes with patient 74 41 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,222 1,173 $4K
99422 103 76 $4K
90472 Immunization administration, each additional vaccine (list separately) 470 452 $3K
99423 40 28 $2K
99442 87 86 $2K
90677 1,374 1,316 $1K
36415 Collection of venous blood by venipuncture 269 256 $973.16
99188 62 62 $892.07
96160 84 77 $757.64
90670 6,750 6,623 $402.92
90686 6,922 6,813 $399.75
80061 Lipid panel 15 15 $200.25
81003 81 80 $160.88
87807 12 12 $143.29
99441 13 13 $118.15
85025 Blood count; complete (CBC), automated, and automated differential WBC count 15 13 $100.55
90474 25 24 $89.88
99199 Unlisted special service, procedure or report 14 14 $80.00
90656 375 373 $41.47
90723 3,620 3,526 $0.00
90647 4,045 3,935 $0.00
90680 2,572 2,473 $0.00
90716 50 49 $0.00
90696 38 38 $0.00
90651 93 92 $0.00
90633 544 528 $0.00
90734 100 100 $0.00
90710 27 27 $0.00
90707 25 25 $0.00
90715 26 26 $0.00
90700 13 13 $0.00