Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1811145014 · GASTONIA, NC 28054 · Pediatrics Physician · NPI assigned 09/03/2008

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

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

$8.57M
Total Medicaid Paid
494,629
Total Claims
376,836
Beneficiaries
59
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date09/03/2008

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 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
CHARLOTTE PEDIATRIC CLINIC MATTHEWS NC $1.76M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 24,728 $736K
2019 27,885 $975K
2020 25,507 $848K
2021 63,200 $1.28M
2022 104,225 $1.56M
2023 122,964 $1.66M
2024 126,120 $1.51M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 37,694 32,909 $2.28M
99199 Unlisted special service, procedure or report 224,257 141,903 $1.19M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 13,073 10,781 $1.08M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 11,584 9,873 $1.05M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 11,644 10,192 $1.05M
90472 Immunization administration, each additional vaccine (list separately) 15,071 12,866 $517K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 22,687 19,600 $415K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,149 3,649 $382K
90460 Immunization administration through 18 years of age via any route, first or only component 4,474 3,897 $225K
96110 Developmental screening, with scoring and documentation, per standardized instrument 16,972 14,992 $76K
90474 3,638 3,027 $64K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 541 461 $51K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 440 391 $26K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,829 1,643 $23K
83655 1,182 1,028 $16K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 356 297 $16K
96127 3,688 3,240 $14K
90677 1,757 1,712 $11K
82465 2,148 1,845 $11K
92551 10,722 9,484 $10K
99381 99 89 $8K
99051 313 308 $7K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 193 147 $6K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 37 36 $6K
0002A 106 67 $4K
0071A 90 65 $4K
85018 8,913 7,846 $4K
99173 10,765 9,500 $3K
0072A 70 50 $3K
99383 28 24 $3K
0001A 63 35 $3K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 52 51 $2K
90686 6,321 5,705 $1K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 25 19 $916.26
90670 8,164 6,843 $474.51
90723 6,370 5,416 $277.35
90680 5,280 4,490 $191.37
96161 77 67 $172.12
87807 12 12 $158.54
99177 1,071 998 $154.56
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) 50 49 $122.54
81003 40 40 $96.95
90656 692 657 $78.40
36416 1,519 1,115 $43.85
90647 5,954 5,066 $29.25
3074F 9,526 8,389 $0.00
90716 1,567 1,303 $0.00
3008F 2,314 2,219 $0.00
90651 90 78 $0.00
91307 152 92 $0.00
90696 94 77 $0.00
90633 2,178 1,865 $0.00
90707 1,679 1,414 $0.00
1160F 8,778 7,956 $0.00
3078F 9,314 8,209 $0.00
1159F 14,624 12,664 $0.00
90734 29 26 $0.00
90700 46 42 $0.00
91308 28 17 $0.00