Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $1.52M by Medicaid between Jan 2018 and Sep 2024, across 34 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 25% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
CHARLOTTE, NC 28211
CHARLOTTE, NC 28211
33aNPI1740299130assigned 08/05/2006
33bProvider typePediatrics Physician
28Total paid$1.52M
24GClaims114,336
24DCodes billed34
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#183 of 433
Median peer was paid$942K
This provider vs. median1.6×
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 | 10,561 | $277K | |
| 2019 | 11,539 | $320K | |
| 2020 | 9,806 | $279K | |
| 2021 | 19,843 | $305K | |
| 2022 | 23,335 | $157K | |
| 2023 | 21,603 | $103K | |
| 2024incomplete | 17,649 | $82K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 25% | 71,693 | 46,789 | $376K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 3,911 | 3,376 | $223K |
| 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 | 15% | 3,011 | 2,441 | $222K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 9.9% | 1,883 | 1,641 | $151K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.7% | 1,927 | 1,432 | $132K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 6.7% | 6,512 | 4,987 | $103K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 6.6% | 3,473 | 2,657 | $101K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.6% | 884 | 759 | $70K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.9% | 350 | 267 | $30K |
| D0145 | Oral evaluation for a patient under three years of age | 1.6% | 940 | 766 | $25K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.2% | 3,620 | 2,620 | $19K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 367 | 319 | $13K |
22 more codes
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 395 | $13K |
| D1206 | Topical application of fluoride varnish | <1% | 938 | $11K |
| 90474 | <1% | 543 | $10K | |
| 96127 | <1% | 2,337 | $8K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 227 | $6K |
| 80061 | Lipid panel | <1% | 169 | $3K |
| 83655 | <1% | 205 | $2K | |
| 90686 | <1% | 2,355 | $1K | |
| 92551 | <1% | 1,510 | $1K | |
| 96161 | <1% | 256 | $825.01 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 15 | $718.34 |
| 90651 | <1% | 29 | $713.70 | |
| 99173 | <1% | 2,254 | $478.68 | |
| 99441 | <1% | 14 | $402.16 | |
| 90734 | <1% | 35 | $289.62 | |
| 85018 | <1% | 862 | $233.01 | |
| 90633 | <1% | 198 | $33.10 | |
| 36416 | <1% | 45 | $21.65 | |
| 90670 | 0% | 1,447 | $0.00 | |
| 90723 | 0% | 687 | $0.00 | |
| 90680 | 0% | 568 | $0.00 | |
| 90647 | 0% | 676 | $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.