Medicaid Provider Spending

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

PROVIDENCE PEDIATRICS

NPI: 1326078072 · CHARLOTTE, NC 28277 · Pediatrics Physician · NPI assigned 07/04/2006

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

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

$747K
Total Medicaid Paid
73,096
Total Claims
51,458
Beneficiaries
35
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationPROVIDENCE PEDIATRICS
NPI Enumeration Date07/04/2006

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
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 420 $15K
2019 580 $27K
2020 567 $16K
2021 7,653 $85K
2022 15,645 $154K
2023 21,570 $200K
2024 26,661 $250K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99199 Unlisted special service, procedure or report 54,732 35,316 $291K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,441 2,991 $198K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 2,050 1,799 $180K
90460 Immunization administration through 18 years of age via any route, first or only component 467 432 $20K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,210 1,026 $19K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 163 140 $13K
99423 90 57 $4K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 37 37 $4K
90472 Immunization administration, each additional vaccine (list separately) 94 80 $3K
99422 49 40 $2K
96127 535 475 $2K
0071A 52 38 $2K
0072A 45 33 $2K
99245 15 12 $2K
96110 Developmental screening, with scoring and documentation, per standardized instrument 404 367 $2K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 15 14 $1K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 31 26 $1K
90686 560 473 $299.56
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 13 12 $193.23
92551 169 164 $119.19
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 20 17 $44.56
99177 89 89 $7.26
1159F 3,178 2,734 $0.00
1160F 2,084 1,886 $0.00
3078F 1,362 1,207 $0.00
90633 32 32 $0.00
3008F 413 392 $0.00
3074F 1,484 1,322 $0.00
3044F 12 12 $0.00
90677 30 29 $0.00
90656 126 124 $0.00
90723 13 12 $0.00
90651 27 27 $0.00
90647 13 12 $0.00
91307 41 31 $0.00