Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1477173292 · GASTONIA, NC 28054 · Sports Medicine (Family Medicine) Physician · NPI assigned 04/22/2020

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

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

$1.19M
Total Medicaid Paid
155,093
Total Claims
103,870
Beneficiaries
31
Codes Billed
2021-05
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date04/22/2020

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
2021 7,863 $91K
2022 19,887 $191K
2023 38,693 $288K
2024 88,650 $621K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99199 Unlisted special service, procedure or report 142,260 93,366 $765K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 5,034 4,075 $321K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 927 721 $50K
99215 Prolong outpt/office vis 518 386 $28K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 214 168 $9K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 96 87 $6K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 28 24 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 146 126 $2K
99442 99 75 $2K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 23 13 $2K
90739 13 12 $1K
83036 Hemoglobin; glycosylated (A1C) 239 192 $1K
90656 68 68 $683.44
99443 19 16 $672.40
82962 236 196 $408.14
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) 254 218 $405.66
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 29 26 $339.68
96127 78 60 $233.72
81003 149 118 $226.03
90686 41 28 $154.20
36415 Collection of venous blood by venipuncture 62 53 $132.89
92552 15 12 $48.45
92551 12 12 $8.02
99173 29 26 $4.02
1159F 1,597 1,346 $0.00
1160F 1,248 1,064 $0.00
3078F 479 393 $0.00
3074F 778 658 $0.00
3044F 173 132 $0.00
3008F 191 172 $0.00
91305 38 27 $0.00