LORI JEAN WILEY, FNP-C
NPI 1013362672, individual, Brazil, IN, Nurse Practitioner, Family
- Hours beyond a day in 1 month, but with up to 343 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 99349 ($233 per patient-month) sit in the top 5% of every provider billing that code.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Nov 2023 | More hours than a day holds at a conservative unit price | 11.5 | 36.8 | 24.5 | 33.4 | 194 | 2 | 99213 99344 99348 99349 | $42K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | LORI JEAN WILEY, FNP-C |
| Type | Individual |
| Status | Active |
| NPI issued | May 2, 2016, last updated May 30, 2023 |
| Practice location | 1214 E NATIONAL AVE STE 90A, Brazil, IN 47834-2746, 812-442-2900 |
| Specialties | Nurse Practitioner, Family (363LF0000X, primary, license 71006248A IN) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $463K | 39% | $57 | $44 (top 5% from $110) | 68th percentile | |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | $317K | 26% | $233 | $30 (top 5% from $115) | 98th percentile | |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | $130K | 11% | $167 | $17 (top 5% from $105) | 96th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $79K | 7% | $93 | $60 (top 5% from $133) | 81st percentile | |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | $61K | 5% | $104 | $94 (top 5% from $327) | 53rd percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $51K | 4% | $47 | $44 (top 5% from $70) | 58th percentile | |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | $21K | 2% | $77 | $71 (top 5% from $112) | 59th percentile | |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | $17K | 1% | $28 | $30 (top 5% from $48) | 41st percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 153 | 27 | $12K | $254 | $100 | 2.5x | 2.0x (90th percentile 3.4x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 96 | 95 | $4K | $130 | $72 | 1.8x | 2.2x (90th percentile 3.8x) |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 16 | 16 | $2K | $150 | $94 | 1.6x | 2.1x (90th percentile 3.7x) |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 27 | 27 | $1K | $77 | $50 | 1.5x | 2.4x (90th percentile 3.7x) |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 14 | 14 | $988 | $361 | $113 | 3.2x | 2.1x (90th percentile 3.5x) |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 12 | 12 | $194 | $29 | $16 | 1.8x | 2.6x (90th percentile 4.1x) |
| 96372 | Injection of drug or substance under skin or into muscle | 16 | 14 | $125 | $40 | $11 | 3.6x | 3.6x (90th percentile 6.4x) |
| 81003 | Automated urinalysis test | 21 | 21 | $46 | $18 | $2 | 8.4x | 4.6x (90th percentile 12.7x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
2 providers in Clay County, IN carry an indicator in the public record, with $13.9M at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | PUTNAM COUNTY HOSPITAL Brazil, IN, ranked 6736 | $0 |
|
| 4 | KATHY OCAMPO Brazil, IN, ranked 8279 | $13.9M |
|
Recent enforcement in IN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.