Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $1.19M by Medicaid between May 2021 and Dec 2024, across 31 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 64% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
GASTONIA, NC 28054
GASTONIA, NC 28054
33aNPI1477173292assigned 04/22/2020
33bProvider typeSports Medicine (Family Medicine) Physician
28Total paid$1.19M
24GClaims155,093
24DCodes billed31
24AFirst – last monthMay 2021 – Dec 2024
Compared with peers
Next to other Sports Medicine (Family Medicine) Physician providers in North Carolina
Rank by total paid#5 of 25
Median peer was paid$326K
This provider vs. median3.7×
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 | |
|---|---|---|---|
| 2021 | 7,863 | $91K | |
| 2022 | 19,887 | $191K | |
| 2023 | 38,693 | $288K | |
| 2024incomplete | 88,650 | $621K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 64% | 142,260 | 93,366 | $765K |
| 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 | 27% | 5,034 | 4,075 | $321K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.2% | 927 | 721 | $50K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 2.3% | 518 | 386 | $28K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 214 | 168 | $9K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 96 | 87 | $6K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 28 | 24 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 146 | 126 | $2K |
| 99442 | <1% | 99 | 75 | $2K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 23 | 13 | $2K |
| 90739 | <1% | 13 | 12 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 239 | 192 | $1K |
19 more codes
| 90656 | <1% | 68 | $683.44 | |
| 99443 | <1% | 19 | $672.40 | |
| 82962 | <1% | 236 | $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) | <1% | 254 | $405.66 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 29 | $339.68 |
| 96127 | <1% | 78 | $233.72 | |
| 81003 | <1% | 149 | $226.03 | |
| 90686 | <1% | 41 | $154.20 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 62 | $132.89 |
| 92552 | <1% | 15 | $48.45 | |
| 92551 | <1% | 12 | $8.02 | |
| 99173 | <1% | 29 | $4.02 | |
| 1159F | 0% | 1,597 | $0.00 | |
| 1160F | 0% | 1,248 | $0.00 | |
| 3078F | 0% | 479 | $0.00 | |
| 3074F | 0% | 778 | $0.00 | |
| 3044F | 0% | 173 | $0.00 | |
| 3008F | 0% | 191 | $0.00 | |
| 91305 | 0% | 38 | $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.