Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $1.62M by Medicaid between Jan 2018 and Dec 2024, across 38 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 69% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
SHELBY, NC 28150
SHELBY, NC 28150
33aNPI1760824700assigned 07/18/2013
33bProvider typeFamily Medicine Physician
28Total paid$1.62M
24GClaims108,993
24DCodes billed38
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in North Carolina
Rank by total paid#76 of 960
Median peer was paid$135K
This provider vs. median12×
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 | 4,675 | $116K | |
| 2019 | 3,734 | $131K | |
| 2020 | 3,215 | $160K | |
| 2021 | 10,418 | $255K | |
| 2022 | 21,239 | $319K | |
| 2023 | 29,664 | $311K | |
| 2024incomplete | 36,048 | $333K |
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 | 69% | 20,074 | 17,619 | $1.12M |
| 99199 | Unlisted special service, procedure or report | 22% | 64,266 | 40,785 | $359K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.2% | 2,031 | 1,684 | $84K |
| 99442 | <1% | 279 | 213 | $9K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,032 | 874 | $6K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 82 | 67 | $5K |
| 99441 | <1% | 252 | 184 | $5K | |
| 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% | 47 | 41 | $5K |
| 36415 | Collection of venous blood by venipuncture | <1% | 3,411 | 2,934 | $5K |
| 0002A | <1% | 109 | 63 | $4K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 833 | 765 | $4K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 105 | 62 | $3K |
26 more codes
| 0001A | <1% | 51 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 173 | $2K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 26 | $2K |
| 90686 | <1% | 185 | $2K | |
| 85027 | <1% | 335 | $1K | |
| 80053 | Comprehensive metabolic panel | <1% | 301 | $1K |
| 80061 | Lipid panel | <1% | 152 | $872.32 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 27 | $528.98 |
| 90656 | <1% | 29 | $383.37 | |
| 1160F | <1% | 2,970 | $128.15 | |
| 1159F | <1% | 4,973 | $128.15 | |
| 96160 | <1% | 34 | $115.10 | |
| 96127 | <1% | 40 | $93.03 | |
| 82570 | <1% | 15 | $64.28 | |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | <1% | 12 | $63.68 |
| 82044 | <1% | 15 | $35.30 | |
| 3008F | 0% | 889 | $0.00 | |
| 3074F | 0% | 2,833 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 73 | $0.00 |
| 3079F | 0% | 503 | $0.00 | |
| 3044F | 0% | 364 | $0.00 | |
| 3075F | 0% | 31 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 27 | $0.00 |
| 91305 | 0% | 21 | $0.00 | |
| 3078F | 0% | 2,379 | $0.00 | |
| 3077F | 0% | 14 | $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.