Medicaid Provider Spending

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

CAROLINAS PHYSICIANS NETWORK INC

NPI: 1902200991 · ALBEMARLE, NC 28001 · Pediatric Adolescent Medicine Physician · NPI assigned 10/20/2014

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

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

$7.73M
Total Medicaid Paid
366,651
Total Claims
280,778
Beneficiaries
67
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRISSMILLER, SCOTT (ENTERPRISE EVP)
Parent OrganizationCAROLINAS PHYSICIANS NETWORK INC
NPI Enumeration Date10/20/2014

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 25,053 $823K
2019 24,885 $1.02M
2020 18,798 $782K
2021 43,560 $1.09M
2022 72,790 $1.39M
2023 91,088 $1.42M
2024 90,477 $1.20M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 34,170 29,364 $2.00M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 20,187 17,272 $1.82M
99199 Unlisted special service, procedure or report 157,973 101,094 $835K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 6,902 5,932 $603K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 7,124 5,634 $563K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,682 4,183 $423K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 4,069 3,587 $246K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,318 1,978 $217K
90460 Immunization administration through 18 years of age via any route, first or only component 4,653 4,156 $214K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 11,784 9,969 $208K
90472 Immunization administration, each additional vaccine (list separately) 6,880 5,736 $204K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 6,115 5,498 $79K
99215 Prolong outpt/office vis 552 489 $70K
96110 Developmental screening, with scoring and documentation, per standardized instrument 10,870 9,302 $48K
96127 9,657 8,461 $36K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 580 476 $25K
99460 328 318 $21K
90474 1,046 862 $18K
99238 Hospital discharge day management, 30 minutes or less 250 246 $14K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 293 247 $12K
87807 780 669 $10K
96161 3,349 2,688 $10K
90651 448 393 $7K
99462 231 194 $7K
90734 574 504 $5K
D0145 Oral evaluation for a patient under three years of age 220 173 $5K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 174 172 $5K
83655 300 261 $4K
92551 5,965 5,336 $4K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 95 84 $3K
90686 3,839 3,413 $3K
99173 9,053 8,008 $2K
90620 60 51 $2K
D1206 Topical application of fluoride varnish 219 172 $2K
0002A 28 25 $2K
0001A 36 20 $1K
95117 98 52 $883.34
0071A 14 13 $804.33
96160 289 256 $778.68
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 79 67 $753.32
80061 Lipid panel 49 39 $638.10
81003 294 244 $613.94
90715 61 56 $313.80
90677 510 492 $260.81
85025 Blood count; complete (CBC), automated, and automated differential WBC count 26 26 $241.29
90670 3,771 3,155 $239.74
90633 686 603 $108.96
86308 12 12 $71.38
36416 233 179 $53.72
85027 13 12 $47.88
85018 71 65 $32.27
1160F 9,480 8,310 $0.00
1159F 16,407 13,616 $0.00
3078F 5,143 4,560 $0.00
99177 112 109 $0.00
G9919 Screening performed and positive and provision of recommendations 33 25 $0.00
90710 15 15 $0.00
90723 2,135 1,853 $0.00
90680 1,651 1,424 $0.00
3074F 5,311 4,692 $0.00
3008F 1,342 1,287 $0.00
90647 2,252 1,943 $0.00
90656 488 463 $0.00
90696 14 14 $0.00
3044F 216 189 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 27 26 $0.00
3079F 15 14 $0.00