Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $1.62M by Medicaid between Jan 2018 and Dec 2024, across 44 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 48% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
FOREST CITY, NC 28043
FOREST CITY, NC 28043
33aNPI1588818512assigned 11/04/2008
33bProvider typeCritical Care Medicine (Internal Medicine) Physician
28Total paid$1.62M
24GClaims87,662
24DCodes billed44
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Critical Care Medicine (Internal Medicine) Physician providers in North Carolina
Rank by total paid#2 of 24
Median peer was paid$62K
This provider vs. median26×
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 | 7,615 | $218K | |
| 2019 | 6,954 | $230K | |
| 2020 | 3,842 | $161K | |
| 2021 | 6,302 | $198K | |
| 2022 | 14,367 | $222K | |
| 2023 | 17,854 | $238K | |
| 2024incomplete | 30,728 | $351K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 48% | 15,083 | 13,442 | $769K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 8,931 | 8,017 | $307K |
| 99199 | Unlisted special service, procedure or report | 16% | 45,345 | 28,879 | $261K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 5.0% | 214 | 204 | $81K |
| 95811 | 4.9% | 181 | 177 | $80K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 2.2% | 337 | 325 | $36K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.1% | 1,938 | 1,556 | $18K |
| 99243 | <1% | 154 | 147 | $12K | |
| 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% | 117 | 102 | $10K |
| 85027 | <1% | 1,603 | 1,433 | $8K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 59 | 37 | $5K |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,193 | 3,724 | $5K |
32 more codes
| 90686 | <1% | 513 | $4K | |
| 99205 | Prolong outpt/office vis | <1% | 32 | $3K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 232 | $2K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 44 | $2K |
| 43235 | <1% | 50 | $2K | |
| 99442 | <1% | 78 | $2K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 307 | $2K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 167 | $1K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 21 | $772.20 |
| 99441 | <1% | 57 | $672.19 | |
| 94060 | <1% | 26 | $538.20 | |
| 80061 | Lipid panel | <1% | 53 | $461.39 |
| 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% | 136 | $422.14 |
| 80053 | Comprehensive metabolic panel | <1% | 103 | $346.71 |
| 90656 | <1% | 18 | $281.98 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 40 | $281.40 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 99 | $275.63 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 16 | $268.49 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 18 | $146.04 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 971 | $133.27 |
| 81003 | <1% | 32 | $69.31 | |
| 84450 | <1% | 15 | $41.34 | |
| 3075F | 0% | 123 | $0.00 | |
| 3044F | 0% | 285 | $0.00 | |
| 3008F | 0% | 590 | $0.00 | |
| 3074F | 0% | 763 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 87 | $0.00 |
| 3079F | 0% | 201 | $0.00 | |
| 1160F | 0% | 1,432 | $0.00 | |
| 3078F | 0% | 866 | $0.00 | |
| 1159F | 0% | 2,104 | $0.00 | |
| 84460 | 0% | 28 | $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.