Physician
Carolinas Medical Center
Carolinas Medical Center was paid $6.42M by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 38% of everything it billed.
33Billing provider infoCAROLINAS MEDICAL CENTER
CHARLOTTE, NC 28213
CHARLOTTE, NC 28213
33aNPI1619013562assigned 01/29/2007
33bProvider typeInternal Medicine Physician
28Total paid$6.42M
24GClaims578,807
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in North Carolina
Rank by total paid#8 of 616
Median peer was paid$74K
This provider vs. median86×
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 | 19,983 | $535K | |
| 2019 | 17,602 | $615K | |
| 2020 | 13,684 | $425K | |
| 2021 | 69,056 | $972K | |
| 2022 | 142,459 | $1.27M | |
| 2023 | 143,911 | $1.26M | |
| 2024incomplete | 172,112 | $1.35M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 38% | 473,994 | 313,168 | $2.47M |
| 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 | 26% | 26,870 | 23,875 | $1.69M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 38,517 | 33,444 | $1.67M |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.8% | 1,698 | 1,504 | $114K |
| 59430 | 1.5% | 1,250 | 1,157 | $99K | |
| 99442 | <1% | 2,259 | 1,735 | $63K | |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | <1% | 558 | 476 | $62K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 2,312 | 1,969 | $44K |
| 99443 | <1% | 938 | 745 | $40K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 5,219 | 4,695 | $24K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 7,332 | 6,826 | $23K |
| 99401 | <1% | 1,160 | 969 | $21K |
18 more codes
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 5,771 | $19K |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | <1% | 383 | $17K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 2,685 | $12K |
| 99381 | <1% | 490 | $10K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 82 | $9K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 141 | $8K |
| 99441 | <1% | 525 | $7K | |
| 96161 | <1% | 5,934 | $6K | |
| 59025 | Fetal non-stress test | <1% | 259 | $5K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 97 | $5K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 87 | $4K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 65 | $4K |
| 0054A | <1% | 27 | $2K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 34 | $1K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 47 | $898.22 |
| 76801 | <1% | 13 | $364.91 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 17 | $200.50 |
| 96160 | <1% | 43 | $44.88 |
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 MEDICAL CENTER
| 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 |
| 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 |
| Charlotte Pediatric Clinic | Matthews, NC | $1.76M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.