Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $727K by Medicaid between Jan 2018 and Dec 2024, across 35 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 43% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
KINGS MOUNTAIN, NC 28086
KINGS MOUNTAIN, NC 28086
33aNPI1487096426assigned 07/18/2013
33bProvider typeObstetrics & Gynecology Physician
28Total paid$727K
24GClaims45,310
24DCodes billed35
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in North Carolina
Rank by total paid#25 of 189
Median peer was paid$47K
This provider vs. median16×
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 | 1,214 | $31K | |
| 2019 | 2,274 | $60K | |
| 2020 | 2,368 | $74K | |
| 2021 | 5,660 | $122K | |
| 2022 | 11,249 | $149K | |
| 2023 | 12,397 | $177K | |
| 2024incomplete | 10,148 | $114K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 43% | 6,409 | 5,169 | $312K |
| 99199 | Unlisted special service, procedure or report | 20% | 24,732 | 13,887 | $143K |
| 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 | 14% | 1,358 | 1,120 | $100K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 4.4% | 424 | 329 | $32K |
| 81025 | 3.6% | 4,141 | 3,343 | $26K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 2.9% | 212 | 194 | $21K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 2.4% | 380 | 320 | $17K |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | 1.8% | 267 | 244 | $13K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.5% | 152 | 120 | $11K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.3% | 688 | 551 | $10K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.1% | 109 | 77 | $8K |
| 76830 | Ultrasound, transvaginal | 1.1% | 106 | 82 | $8K |
23 more codes
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | 1.1% | 60 | $8K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,074 | $4K |
| 76801 | <1% | 33 | $3K | |
| 96127 | <1% | 903 | $3K | |
| 82950 | <1% | 289 | $2K | |
| 85018 | <1% | 561 | $1K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 14 | $947.64 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 68 | $850.05 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 24 | $560.80 |
| 99459 | <1% | 52 | $495.55 | |
| 81003 | <1% | 180 | $331.07 | |
| Q0111 | Wet mounts, including preparations of vaginal, cervical or skin specimens | <1% | 96 | $307.55 |
| 90686 | <1% | 21 | $281.35 | |
| Q0112 | All potassium hydroxide (koh) preparations | <1% | 32 | $167.61 |
| 81002 | <1% | 48 | $141.75 | |
| 87210 | <1% | 75 | $64.16 | |
| 3074F | 0% | 388 | $0.00 | |
| 3008F | 0% | 175 | $0.00 | |
| 0500F | 0% | 35 | $0.00 | |
| 59430 | 0% | 16 | $0.00 | |
| 1159F | 0% | 614 | $0.00 | |
| 1160F | 0% | 346 | $0.00 | |
| 3078F | 0% | 228 | $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.