Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $400K by Medicaid between Jan 2018 and Nov 2024, across 18 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 52% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
SHELBY, NC 28150
SHELBY, NC 28150
33aNPI1619319621assigned 07/19/2013
33bProvider typeNeurological Surgery Physician
28Total paid$400K
24GClaims7,815
24DCodes billed18
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Neurological Surgery Physician providers in North Carolina
Rank by total paid#2 of 22
Median peer was paid$6K
This provider vs. median69×
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 | 956 | $36K | |
| 2019 | 906 | $31K | |
| 2020 | 646 | $26K | |
| 2021 | 822 | $31K | |
| 2022 | 1,260 | $71K | |
| 2023 | 1,345 | $74K | |
| 2024incomplete | 1,880 | $131K |
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 | 52% | 4,780 | 4,126 | $208K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 11% | 829 | 677 | $46K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 10% | 152 | 100 | $41K |
| 99245 | 8.8% | 308 | 286 | $35K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 7.1% | 306 | 263 | $29K |
| 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 | 3.8% | 237 | 197 | $15K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.1% | 310 | 247 | $9K |
| 99205 | Prolong outpt/office vis | 1.4% | 70 | 58 | $6K |
| 64615 | 1.1% | 73 | 63 | $5K | |
| 95816 | 1.1% | 351 | 246 | $4K | |
| 99442 | <1% | 46 | 33 | $900.89 | |
| 99199 | Unlisted special service, procedure or report | <1% | 121 | 121 | $864.11 |
6 more codes
| 99443 | <1% | 24 | $754.92 | |
| 95819 | <1% | 18 | $339.50 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 18 | $277.26 |
| 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% | 88 | $205.14 |
| 1159F | 0% | 42 | $0.00 | |
| 1160F | 0% | 42 | $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.