Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1538415906 · MONROE, NC 28110 · Pediatric Sports Medicine Physician · NPI assigned 08/03/2012

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

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

$6.55M
Total Medicaid Paid
405,891
Total Claims
307,383
Beneficiaries
66
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date08/03/2012

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 26,136 $742K
2019 29,437 $908K
2020 21,950 $730K
2021 52,228 $1000K
2022 87,085 $1.18M
2023 93,035 $1.08M
2024 96,020 $920K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 19,902 17,405 $1.22M
99199 Unlisted special service, procedure or report 207,052 132,800 $1.09M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 9,653 7,553 $799K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 9,085 8,107 $784K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 7,296 6,595 $654K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,646 4,227 $427K
90460 Immunization administration through 18 years of age via any route, first or only component 7,665 6,722 $368K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,728 2,388 $273K
90472 Immunization administration, each additional vaccine (list separately) 6,574 5,832 $214K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 11,590 10,338 $209K
96110 Developmental screening, with scoring and documentation, per standardized instrument 14,249 12,781 $60K
80061 Lipid panel 3,877 3,424 $60K
D0145 Oral evaluation for a patient under three years of age 1,964 1,742 $53K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 783 759 $50K
96127 8,714 7,800 $35K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,404 2,244 $32K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 10,322 9,047 $32K
90651 1,199 1,080 $25K
D1206 Topical application of fluoride varnish 1,966 1,741 $23K
83655 1,529 1,311 $20K
90474 1,120 991 $20K
99442 398 345 $17K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 414 368 $15K
96161 4,956 3,702 $14K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 271 244 $13K
99381 67 66 $6K
90734 682 570 $6K
90686 6,463 5,846 $5K
92551 5,060 4,661 $5K
0072A 74 53 $3K
99173 9,638 8,686 $3K
0071A 77 54 $3K
99441 82 72 $2K
0001A 43 29 $2K
88720 311 199 $1K
0002A 21 20 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 59 56 $590.44
87807 44 42 $580.92
90620 93 74 $561.20
90715 114 95 $548.62
90670 5,087 4,400 $484.63
81003 184 175 $438.93
36415 Collection of venous blood by venipuncture 147 127 $404.48
99422 35 29 $377.54
90677 797 758 $288.66
90723 3,974 3,496 $281.11
90633 2,392 2,082 $266.98
90680 3,344 2,925 $190.42
85027 19 14 $130.60
90647 3,899 3,464 $57.92
36416 2,240 1,723 $22.12
99177 55 55 $3.63
3074F 3,299 2,906 $0.00
91307 126 75 $0.00
3008F 695 683 $0.00
90656 337 326 $0.00
90716 189 164 $0.00
90696 74 65 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 59 56 $0.00
3078F 3,136 2,783 $0.00
1160F 4,231 3,825 $0.00
1159F 7,860 6,713 $0.00
90700 231 211 $0.00
90707 173 148 $0.00
90710 103 92 $0.00
90685 20 19 $0.00