Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $2.57M by Medicaid between Jan 2018 and Dec 2024, across 34 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 63% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
MONROE, NC 28112
MONROE, NC 28112
33aNPI1376898148assigned 07/18/2012
33bProvider typeInternal Medicine Physician
28Total paid$2.57M
24GClaims195,824
24DCodes billed34
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in North Carolina
Rank by total paid#24 of 616
Median peer was paid$74K
This provider vs. median35×
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 | 5,475 | $189K | |
| 2019 | 4,958 | $269K | |
| 2020 | 2,589 | $152K | |
| 2021 | 15,146 | $282K | |
| 2022 | 32,937 | $346K | |
| 2023 | 44,458 | $444K | |
| 2024incomplete | 90,261 | $891K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 63% | 25,966 | 22,760 | $1.61M |
| 99199 | Unlisted special service, procedure or report | 26% | 127,075 | 86,494 | $662K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 10% | 5,168 | 4,521 | $258K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 855 | 755 | $14K |
| 0002A | <1% | 182 | 111 | $7K | |
| 0001A | <1% | 148 | 86 | $5K | |
| 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) | <1% | 1,731 | 1,586 | $4K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,110 | 1,899 | $3K |
| 99442 | <1% | 105 | 71 | $3K | |
| 99441 | <1% | 109 | 79 | $2K | |
| 90686 | <1% | 334 | 305 | $1K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 23 | 16 | $1K |
22 more codes
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 18 | $872.98 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 19 | $691.30 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 99 | $608.72 |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 24 | $434.48 |
| 90656 | <1% | 53 | $379.74 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 14 | $351.93 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 42 | $288.66 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 15 | $165.79 |
| 81003 | <1% | 13 | $24.93 | |
| 92551 | <1% | 32 | $10.02 | |
| 99173 | <1% | 65 | $2.00 | |
| 3044F | 0% | 1,544 | $0.00 | |
| 3008F | 0% | 2,325 | $0.00 | |
| 3074F | 0% | 5,322 | $0.00 | |
| 3079F | 0% | 519 | $0.00 | |
| 91305 | 0% | 18 | $0.00 | |
| 3075F | 0% | 25 | $0.00 | |
| 1160F | 0% | 8,424 | $0.00 | |
| 1159F | 0% | 9,685 | $0.00 | |
| 3078F | 0% | 3,704 | $0.00 | |
| 3077F | 0% | 14 | $0.00 | |
| 91300 | 0% | 44 | $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.