| 194 | 1 | JOSEPH JURAND 1841280765, individual, Martinsburg | WV | 95 | $48K | - Listed on the MD Medicaid exclusion list since September 11, 2015.
- Medicaid still paid claims in 8 later months, $47,640 in total.
|
| 202 | 1 | MICHAEL SHRAMOWIAT LLC 1003820374, organization, Vienna | WV | 95 | $43K | - Listed on the Medicare revocation list since November 19, 2014.
- Medicaid still paid claims in 21 later months, $42,976 in total.
|
| 289 | 1 | SHAWN BLANKENSHIP 1851744437, individual, Charleston | WV | 94 | $0 | - Adjudicated (pleaded guilty) per a state attorney general release dated March 20, 2025.
- No Medicaid payments in the last 12 observed months.
- Hours beyond a day in 8 months, but with up to 1308 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code G0482 ($281 per patient-month) sit in the top 5% of every provider billing that code.
- A second detector adds a weaker signal.
|
| 314 | 1 | HUGH SMITH 1821484510, individual, Charleston | WV | 94 | $6K | - Listed on the Medicare revocation list since January 7, 2021.
- Medicaid still paid claims in 5 later months, $6,083 in total.
|
| 428 | 1 | WILLIAM EARLEY 1770595043, individual, Vienna | WV | 92 | $265 | - Listed on the SC Medicaid exclusion list since May 1, 2018.
- Medicaid still paid claims in 1 later month, $265 in total.
|
| 557 | 1 | HOLISTIC, INC 1811405616, organization, Charleston | WV | 90 | $0 | - Adjudicated (pleaded guilty) per a state attorney general release dated March 20, 2025.
- No Medicaid payments in the last 12 observed months.
|
| 1665 | 3 | BRIAN MCDEVITT 1821152182, individual, Chapmanville | WV | 63 | $915 | - Charged (indicted) per a Department of Justice release dated June 27, 2024, not adjudicated.
- Medicaid paid $915 in the last 12 observed months.
|
| 2693 | 3 | HARRELL NURSING HOME 1396729869, organization, Charleston | WV | 60 | $0 | - Part of provider network D1-00115, ranked 115 nationally.
|
| 2777 | 3 | FAIRHAVEN OPCO, LLC 1295111565, organization, Huntington | WV | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
|
| 3277 | 3 | AMEDISYS WEST VIRGINIA, L.L.C. 1427240183, organization, Bluefield | WV | 60 | $0 | - Part of provider network D1-00071, ranked 71 nationally.
|
| 4221 | 3 | EWV HOLDINGS, LLC 1437785623, organization, Elizabeth | WV | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
|
| 6406 | 3 | WEST VIRGINIA SLEEP CENTERS 1689912214, organization, Beckley | WV | 60 | $0 | - Charged (complaint) per a Department of Justice release dated June 23, 2026, not adjudicated.
|
| 6993 | 3 | 101 13TH STREET OPERATIONS LLC 1912181223, organization, Huntington | WV | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
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| 7228 | 3 | AMEDISYS HOSPICE, L.L.C. 1902064892, organization, Bluefield | WV | 60 | $0 | - Part of provider network D1-00071, ranked 71 nationally.
|
| 7525 | 4 | MOHAMAD KALOU 1619065190, individual, Charleston | WV | 56 | $3.4M | - Hours beyond a day in 17 months, but with up to 2967 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 80307 ($183 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7761 | 4 | ISAAC ALEXIS 1447313762, individual, Buckeye | WV | 55 | $1.4M | - Hours beyond a day in 4 months, but with up to 809 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99406 ($198 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7795 | 4 | HEATHER ROSEN-TURLEY 1477793735, individual, Keyser | WV | 55 | $1.2M | - Hours beyond a day in 1 month, but with up to 663 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99214 ($137 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7917 | 4 | MARY HACKNEY 1639326747, individual, Buckhannon | WV | 55 | $575K | - Hours beyond a day in 2 months, but with up to 1071 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99213 ($132 per patient-month) sit in the top 5% of every provider billing that code.
|
| 8008 | 4 | LUCINDA MCCARTNEY 1881843258, individual, Morgantown | WV | 54 | $255K | - Hours beyond a day in 1 month, but with up to 916 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99213 ($127 per patient-month) sit in the top 5% of every provider billing that code.
|
| 8063 | 4 | YUANHUI ZHANG 1841305257, individual, Princeton | WV | 54 | $114K | - Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99232 ($331 per patient-month) sit in the top 5% of every provider billing that code.
|
| 8203 | 4 | DONNA MURRAY 1134206931, individual, Beckley | WV | 53 | $758K | - Hours beyond a day in 1 month, but with up to 577 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- 75% of Medicaid dollars are on codes with a history of abuse.
|
| 8603 | 4 | MUHAMMAD SALMAN 1649326075, individual, Bridgeport | WV | 51 | $2.7M | - Hours beyond a day in 3 months, but with up to 1482 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8749 | 4 | HASSAN JAFARY 1184771016, individual, Beckley | WV | 51 | $1.9M | - Hours beyond a day in 18 months, but with up to 1035 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 9202 | 4 | FAY SMITH 1942679030, individual, Martinsburg | WV | 51 | $517K | - Hours beyond a day in 2 months under one organization, which can be supervisory billing.
- Records needed.
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| 9533 | 4 | KARTHIK RAMAKRISHNAN 1942248943, individual, Beckley | WV | 50 | $137K | - Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
|
| 9546 | 4 | IMRAN KHAWAJA 1790740967, individual, Huntington | WV | 50 | $126K | - Hours beyond a day in 1 month, but with up to 136 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 9578 | 4 | ZEID KHITAN 1881659555, individual, Huntington | WV | 50 | $87K | - Hours beyond a day in 1 month, but with up to 98 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 9674 | 4 | SUBHASH VYAS 1083644702, individual, Williamson | WV | 50 | $35K | - Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
|
| 10030 | 5 | ELEONORA GREY 1053604728, individual, Ronceverte | WV | 35 | $1.5M | - Medicaid dollars per patient on code 99406 ($146 per patient-month) sit in the top 5% of every provider billing that code.
|
| 10200 | 5 | THOMAS LAUDERMAN 1891713582, individual, Salem | WV | 35 | $656K | - Medicaid dollars per patient on code 99406 ($112 per patient-month) sit in the top 5% of every provider billing that code.
|
| 10247 | 5 | SANJAY BHARTI 1376515692, individual, Morgantown | WV | 35 | $530K | - Medicaid dollars per patient on code 99284 ($356 per patient-month) sit in the top 5% of every provider billing that code.
|
| 10378 | 5 | JAMES ABEL 1376729244, individual, Fairmont | WV | 34 | $222K | - Medicaid dollars per patient on code 99232 ($240 per patient-month) sit in the top 5% of every provider billing that code.
|
| 10478 | 5 | NITIN SANGRAMPURKAR 1598076291, individual, Charleston | WV | 34 | $72K | - Medicaid dollars per patient on code 99239 ($256 per patient-month) sit in the top 5% of every provider billing that code.
|
| 10899 | 5 | BYRON SMITH 1598708307, individual, Princeton | WV | 31 | $1.5M | |
| 10919 | 5 | MUSTAFA RAHIM 1831289891, individual, Beckley | WV | 31 | $1.4M | |
| 10935 | 5 | CAMDEN-CLARK PHYSICIAN CORPORATION 1710125430, organization, Parkersburg | WV | 31 | $1.3M | |
| 11091 | 5 | SAMANTHA SHAWVER 1336505049, individual, Charleston | WV | 31 | $825K | |
| 11305 | 5 | TIARA DEAN 1639614019, individual, Morgantown | WV | 31 | $364K | |
| 11308 | 5 | MICHELLE CARDI 1528503513, individual, Morgantown | WV | 31 | $358K | |
| 11613 | 5 | SCOTT KEFFER 1700878881, individual, Ansted | WV | 30 | $110K | |
| 11639 | 5 | FUAD ZEID 1134184526, individual, Huntington | WV | 30 | $94K | |
| 11655 | 5 | MOHAMMED AL-OURANI 1245462290, individual, Huntington | WV | 30 | $88K | |
| 11687 | 5 | IHEANYICHUKWU OGU 1992093678, individual, Huntington | WV | 30 | $74K | |
| 11788 | 5 | DANIEL FARMER 1710286968, individual, Morgantown | WV | 30 | $41K | |
| 11798 | 5 | YOUSEF SHWEIHAT 1407060015, individual, Huntington | WV | 30 | $39K | |
| 11829 | 5 | TRACY LEGROW 1154602571, individual, Huntington | WV | 29 | $31K | |
| 11870 | 5 | ALLISSA CAUDILL 1548558695, individual, Huntington | WV | 29 | $21K | |
| 11891 | 5 | JENNIFER PRICE 1225339153, individual, Charleston | WV | 29 | $17K | |