Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1760824700 · SHELBY, NC 28150 · Family Medicine Physician · NPI assigned 07/18/2013

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official RISSMILLER, SCOTT controls 20+ related entities in our dataset. Read more

$1.62M
Total Medicaid Paid
108,993
Total Claims
80,054
Beneficiaries
38
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date07/18/2013

Related Entities

Other providers sharing the same authorized official: RISSMILLER, SCOTT

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 36,048 $333K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 20,074 17,619 $1.12M
99199 Unlisted special service, procedure or report 64,266 40,785 $359K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,031 1,684 $84K
99442 279 213 $9K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1,032 874 $6K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 82 67 $5K
99441 252 184 $5K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 47 41 $5K
36415 Collection of venous blood by venipuncture 3,411 2,934 $5K
0002A 109 63 $4K
83036 Hemoglobin; glycosylated (A1C) 833 765 $4K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 105 62 $3K
0001A 51 42 $3K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 173 149 $2K
99215 Prolong outpt/office vis 26 24 $2K
90686 185 163 $2K
85027 335 289 $1K
80053 Comprehensive metabolic panel 301 280 $1K
80061 Lipid panel 152 140 $872.32
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 27 16 $528.98
90656 29 26 $383.37
1160F 2,970 2,737 $128.15
1159F 4,973 4,389 $128.15
96160 34 26 $115.10
96127 40 38 $93.03
82570 15 13 $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 12 12 $63.68
82044 15 13 $35.30
3008F 889 846 $0.00
3074F 2,833 2,520 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 73 70 $0.00
3079F 503 462 $0.00
3044F 364 322 $0.00
3075F 31 28 $0.00
G0008 Administration of influenza virus vaccine 27 26 $0.00
91305 21 16 $0.00
3078F 2,379 2,103 $0.00
3077F 14 13 $0.00