Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Carolinas Physicians Network INC

Carolinas Physicians Network INC was paid $3.89M by Medicaid between Dec 2020 and Dec 2024, across 56 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 21% of everything it billed.

33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
CHARLOTTE, NC 28216
33aNPI1619582343assigned 09/10/2020
33bProvider typePediatrics Physician
28Total paid$3.89M
24GClaims204,925
24DCodes billed56
24AFirst – last monthDec 2020 – Dec 2024
Compared with peers

Next to other Pediatrics Physician providers in North Carolina

Rank by total paid#103 of 433
Median peer was paid$942K
This provider vs. median4.1×

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

$0$50K$100K$150K2018201920202021202220232024
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
YearClaimsPaid
202019$1K
202119,502$551K
202231,691$823K
202358,280$1.19M
2024incomplete95,433$1.33M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 21% 12,869 10,663 $815K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 17% 7,836 5,953 $672K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 13% 5,040 4,346 $493K
99199 Unlisted special service, procedure or report 12% 94,630 62,787 $479K
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 11% 4,611 3,800 $424K
90460 Immunization administration through 18 years of age via any route, first or only component 8.2% 6,433 5,730 $320K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 6.6% 2,723 2,336 $258K
90472 Immunization administration, each additional vaccine (list separately) 3.1% 3,664 2,950 $121K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2.8% 6,239 5,009 $109K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1.7% 646 556 $67K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 6,413 5,612 $21K
90474 <1% 920 769 $16K
44 more codes
90677 <1% 1,653 $16K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 187 $11K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 202 $9K
96127 <1% 2,461 $9K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 699 $9K
99383 <1% 78 $9K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 178 $7K
96161 <1% 1,681 $4K
0071A <1% 118 $4K
99384 <1% 29 $3K
0072A <1% 65 $3K
83655 <1% 189 $3K
90651 <1% 351 $2K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 434 $2K
90670 <1% 2,717 $1K
80061 Lipid panel <1% 54 $875.01
0001A <1% 26 $776.80
90734 <1% 106 $451.84
88720 <1% 88 $405.71
92552 <1% 380 $341.29
90686 <1% 2,216 $326.22
90723 <1% 2,925 $302.15
99173 <1% 962 $291.89
96160 <1% 89 $276.76
92551 <1% 257 $258.00
90680 <1% 2,214 $190.42
85018 <1% 283 $149.55
90633 <1% 1,162 $110.86
90715 <1% 28 $89.36
90647 <1% 2,743 $88.05
90656 <1% 782 $80.12
90700 <1% 42 $34.50
36416 <1% 202 $15.80
99177 <1% 274 $2.61
1160F 0% 6,372 $0.00
1159F 0% 10,572 $0.00
3078F 0% 3,844 $0.00
90707 0% 424 $0.00
90710 0% 34 $0.00
3074F 0% 3,996 $0.00
3008F 0% 1,226 $0.00
90696 0% 32 $0.00
90716 0% 402 $0.00
91307 0% 124 $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
Same official

Other billing entities under RISSMILLER, SCOTT

Full network →
ProviderLocationPaid
Carolinas Medical CenterCharlotte, NC$52.97M
Cotswold Family MedicineCharlotte, NC$12.51M
Carolinas Physicians Network INC.Charlotte, NC$8.93M
Carolinas Physicians Network INCGastonia, NC$8.57M
Carolinas Physicians Network INCRock Hill, SC$8.47M
University PediatricsCharlotte, NC$8.22M
Carolinas Medical CenterCharlotte, NC$6.42M
Eastland Urgent CareCharlotte, NC$5.05M
Carolinas Physicians Network INCCharlotte, NC$4.24M
University PediatricsCharlotte, NC$3.22M
Carolinas Physicians Network INCFort Mill, SC$3.04M
Carolinas Physicians Network INCConcord, NC$2.91M
Carolinas Medical CenterCharlotte, NC$2.82M
Charlotte Pediatric ClinicCharlotte, NC$2.46M
Carolinas Physicians Network INCConcord, NC$2.38M
Pediatric Endocrinology & Diabetes SpecialistsCharlotte, NC$2.27M
Carolinas Physicians Network INCCharlotte, NC$2.06M
Carolinas Physicians Network INCKannapolis, NC$1.98M
Arboretum PediatricsCharlotte, NC$1.92M
Carolinas Physicians Network INCCharlotte, NC$1.91M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.