Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1548664303 · TROY, NC 27371 · Internal Medicine Physician · NPI assigned 10/22/2014

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

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

$2.25M
Total Medicaid Paid
122,858
Total Claims
91,039
Beneficiaries
47
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date10/22/2014

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 7,680 $245K
2019 7,847 $331K
2020 5,551 $250K
2021 14,214 $372K
2022 24,965 $397K
2023 30,334 $346K
2024 32,267 $307K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 11,813 10,013 $774K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 12,398 10,236 $650K
99199 Unlisted special service, procedure or report 64,090 41,422 $342K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,129 951 $101K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,226 973 $100K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,198 787 $78K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,058 2,561 $52K
90472 Immunization administration, each additional vaccine (list separately) 1,309 1,090 $46K
90460 Immunization administration through 18 years of age via any route, first or only component 460 420 $20K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 238 189 $20K
D0145 Oral evaluation for a patient under three years of age 335 293 $11K
99442 289 225 $9K
96110 Developmental screening, with scoring and documentation, per standardized instrument 1,248 963 $8K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 141 115 $7K
D1206 Topical application of fluoride varnish 335 294 $5K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 417 344 $5K
99401 264 146 $4K
90686 1,384 1,228 $4K
36415 Collection of venous blood by venipuncture 1,979 1,739 $3K
0001A 44 29 $2K
90474 88 75 $2K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 32 26 $1K
0002A 18 16 $1K
92551 1,131 1,026 $786.53
90656 80 77 $416.31
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 31 28 $410.33
83036 Hemoglobin; glycosylated (A1C) 55 52 $389.88
99173 1,625 1,469 $389.19
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) 52 50 $177.37
90734 12 12 $133.90
81003 83 68 $125.00
1159F 4,769 4,056 $0.00
1160F 2,766 2,480 $0.00
3078F 3,068 2,651 $0.00
90633 39 36 $0.00
90670 501 407 $0.00
90710 48 36 $0.00
3008F 580 553 $0.00
3074F 3,405 2,935 $0.00
3079F 443 381 $0.00
G0008 Administration of influenza virus vaccine 13 13 $0.00
3044F 281 241 $0.00
90647 208 178 $0.00
90723 26 25 $0.00
90680 102 87 $0.00
3075F 29 28 $0.00
90651 18 15 $0.00