Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1245759166 · CONCORD, NC 28025 · Pediatric Sports Medicine Physician · NPI assigned 09/12/2017

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

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

$9.99M
Total Medicaid Paid
551,062
Total Claims
409,962
Beneficiaries
56
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date09/12/2017

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 28,537 $990K
2019 29,880 $1.21M
2020 24,280 $970K
2021 73,808 $1.61M
2022 122,522 $1.96M
2023 135,020 $1.76M
2024 137,015 $1.48M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 61,014 53,041 $3.66M
99199 Unlisted special service, procedure or report 296,458 187,555 $1.58M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 10,684 8,616 $882K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 9,414 8,294 $854K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 8,239 7,201 $739K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 6,418 5,661 $569K
90472 Immunization administration, each additional vaccine (list separately) 14,422 12,363 $509K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 24,728 21,240 $444K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,438 2,018 $212K
90460 Immunization administration through 18 years of age via any route, first or only component 3,361 2,876 $159K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,937 1,609 $88K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 1,225 1,119 $76K
96110 Developmental screening, with scoring and documentation, per standardized instrument 14,580 12,764 $66K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 3,382 3,133 $45K
90474 1,273 1,055 $22K
96127 4,254 3,689 $16K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 425 352 $16K
99215 Prolong outpt/office vis 70 62 $9K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1,720 1,558 $8K
90686 7,624 6,757 $5K
90651 256 218 $5K
92551 4,349 3,935 $3K
99173 10,418 9,258 $3K
90734 292 249 $3K
83655 139 129 $2K
80061 Lipid panel 69 67 $1K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 31 21 $992.14
87807 68 61 $890.20
0001A 22 12 $722.00
90677 870 825 $521.62
90670 4,466 3,783 $467.22
96161 177 154 $464.52
96160 135 120 $415.29
99051 13 13 $317.76
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 13 13 $302.40
90716 561 506 $249.82
90707 563 509 $145.70
90723 2,600 2,190 $114.05
90647 2,427 2,102 $87.52
90656 608 579 $39.10
36415 Collection of venous blood by venipuncture 13 13 $32.40
90633 757 703 $32.22
36416 465 363 $25.29
81003 13 13 $16.68
3074F 6,248 5,696 $0.00
3008F 1,890 1,823 $0.00
90680 1,769 1,492 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 154 133 $0.00
90696 14 13 $0.00
91307 19 13 $0.00
1160F 11,869 10,869 $0.00
3078F 6,150 5,613 $0.00
1159F 19,802 17,358 $0.00
90685 126 123 $0.00
99177 13 13 $0.00
G9919 Screening performed and positive and provision of recommendations 17 17 $0.00