Physician
Carolinas Physicians Network INC
Carolinas Physicians Network INC was paid $2.59M by Medicaid between Jan 2018 and Jan 2022, across 20 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 57% of everything it billed.
33Billing provider infoCAROLINAS PHYSICIANS NETWORK INC
CHARLOTTE, NC 28211
CHARLOTTE, NC 28211
33aNPI1912227935assigned 06/02/2010
33bProvider typePediatrics Physician
28Total paid$2.59M
24GClaims51,654
24DCodes billed20
24AFirst – last monthJan 2018 – Jan 2022
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#136 of 433
Median peer was paid$942K
This provider vs. median2.7×
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 | 14,662 | $697K | |
| 2019 | 17,220 | $905K | |
| 2020 | 9,557 | $546K | |
| 2021 | 10,165 | $430K | |
| 2022 | 50 | $13K |
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 | 57% | 17,834 | 16,829 | $1.49M |
| 99051 | 15% | 15,916 | 14,579 | $382K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 5,659 | 4,676 | $312K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 4.3% | 1,801 | 1,724 | $112K |
| 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 | 3.1% | 606 | 579 | $79K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.6% | 5,133 | 4,886 | $68K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.6% | 1,896 | 1,254 | $68K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.1% | 395 | 297 | $29K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 160 | 138 | $15K |
| 69210 | <1% | 349 | 333 | $13K | |
| Q0247 | Injection, sotrovimab, 500 mg | <1% | 28 | 19 | $7K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 662 | 497 | $6K |
8 more codes
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring | <1% | 22 | $6K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 203 | $4K |
| 94664 | <1% | 201 | $2K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 149 | $1K |
| 80047 | <1% | 16 | $374.22 | |
| 81003 | <1% | 133 | $343.48 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 18 | $37.80 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 0% | 473 | $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.